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SCIENTIFIC LITERATURE · MED

Gender Is the Main Predictor of Wearing-Off and Dyskinesia in Levodopa-Naïve Patients with Parkinson's Disease.

Pellecchia MT, Picillo M, Russillo MC, Amboni M, Arabia G, Avanzino L, Canesi M, Catania A, Ceravolo R, Cicero CE, Cilia R, Colangelo I, Dati G, De Micco R, De Rosa A, Di Fonzo A, Eleopra R, Fetoni V, Garavaglia B, Giglio A, Giuntini M, Invernizzi F, Lazzeri G, Marchese R, Nicoletti A, Pacchetti C, Panteghini C, Pilleri M, Radicati F, Reale C, Scaglione C, Soricelli A, Stocchi F, Tessitore A, Vacca L, Volontè MA, Volpi G, Zangaglia R, Amato F, Ricciardi C, Russo M, Barone P.

Mov Disord Clin Pract · 2025-05-29

DOI: 10.1002/mdc3.70143PMID: 40439072

Open accessResearch Support, Non-U.S. Gov't; research-article; Multicenter Study; Journal Article; Observational StudyOriginal source ↗

Research overview

The text below is the source article’s original abstract under a verified reuse license. cc by

BackgroundEvidence suggests that female gender represents a risk factor for the development of motor/nonmotor fluctuations and dyskinesia in Parkinson's disease (PD). So far, no prospective study has analyzed this aspect in relation to the introduction of levodopa treatment.ObjectiveThis prospective multicenter study aims to assess the development of motor/nonmotor fluctuations and dyskinesia based on gender over a 2-year observation period in PD patients starting levodopa.MethodsTwo hundred and eighty-nine PD patients requiring levodopa at baseline were enrolled at 17 Movement Disorders Centers and followed for 2 years. Gender differences in the development of fluctuations, defined as a score ≥2 in the 19-item Wearing-Off Questionnaire, and dyskinesia, defined by Movement Disorders Society Unified Parkinson's Disease Rating Scale Part IV (MDS-UPDRS-IV) score >0 on item 4.1 were assessed. Baseline predictors of such complications were evaluated by stepwise multivariate logistic regression analysis.ResultsTwo hundred and sixteen patients (139 men, 77 women) completed the follow-up (M24). By M24, 53,2% of men and 64.9% of women had fluctuations (P = 0.048), whereas 5% of men and 14.3% of women developed dyskinesia (P = 0.0185). Multivariate analysis showed that female gender significantly predicted wearing-off (Odds ratio [OR] = 1.930; P = 0.0333), whereas older age was a significant protective factor (for 5-year increase: OR = 0.712; P ConclusionsFemale gender was the strongest predictor of fluctuations and dyskinesia after 2-year intake of levodopa. This finding could have important implications for the development of gender-oriented therapeutic recommendations in early PD.

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