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Early development of levodopa-induced dyskinesias and response fluctuations in young-onset Parkinson's disease

Department of Neurology (Drs. Kostic and Sternic), School of Medicine, Belgrade, Yugoslavia; and the Movement Disorder Group (Drs. Kostic and Pnedborski). Neurological Institute and Irving Center for Clinical Research (E. Flaster). College of Physicians and Surgeons, Columbia University, New York, NY.

We evaluated whether patients with young-onset Parkinson's disease (PD) (onset between 21 and 40 years) develop levodopa-induced dyskinesias and motor response fluctuations more frequently and earlier than patients with older- onset PD (onset after 40 years) by determining the period from levodopa introduction to development of dyskinesias or fluctuations in 25 young-onset (mean age at onset, 33.54 years) and in 25 matched older-onset PD patients (mean age at onset, 55.76 years). Young-onset PD patients had significantly higher frequency for both dyskinesias and fluctuations after both 3 and 5 years of levodopa. Young-onset PD patients also developed both levodopa-induced dyskinesias and fluctuations earlier than older-onset PD patients. We suggest that the introduction of levodopa therapy in patients with young-onset PD should be postponed as long as possible.

Address correspondence and reprint requests to Dr. Vladimir S. Kostic, Neurological Institute, Black Building, Room 307, Columbia University, 630 West 168th Street, New York, NY 10032.

V.K. is a Fulbright Fellow and S.P. is a Research Assistant of the National Fund for Scientific Research (Belgium) and is supported by the Parkinson's Disease Foundation (NY, USA). The Irving Center for Clinical Research is supported by NIH grant no. M01-RR-00645.

Presented in part at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, FL, April 1990, and at the 1st International Congress of Movement Disorder.

Received March 16, 1990. Accepted for publication in final form July 3, 1990.

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