Identifying Risk Factors and Constructing Predictive Models for Wearing-Off and Dyskinesia in Chinese Patients With Parkinson's Disease on Long-Term Levodopa Therapy.

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AimsThis study aimed to investigate the incidence and risk factors of motor complications including wearing-off (WO) and dyskinesia during long-term levodopa (LD) therapy in Chinese patients with Parkinson's disease (PD), and develop corresponding predictive models, thereby providing a basis for personalized treatment strategies.MethodsThis cross-sectional study included 208 consecutive PD patients who were recruited. The presence of WO and dyskinesia was assessed by a 9-item wearing-off questionnaire and the Unified Parkinson's Disease Rating Scale part IV. Univariate and multivariate logistic regression analyses were used to predict the risk factors of WO and dyskinesia. Predictive models for WO and dyskinesia were then constructed, and their diagnostic performance was evaluated using the area under the curve (AUC).ResultsThe overall prevalence rate of motor complications was 46.2% (96/208), with a prevalence of 45.7% (95/208) for WO, 22.1% (46/208) for dyskinesia, and 21.6% (45/208) for the simultaneous occurrence of WO and dyskinesia. Younger age at onset (OR 0.92, p ConclusionOur findings suggest that the prevalence of motor complications during long-term LD treatment is relatively high among PD patients in China, with WO occurring more commonly than dyskinesia. Younger age at PD onset, higher LEDD, more severe disease, and akinetic-rigid subtype are key predictors of motor complications. The predictive models developed in this study could serve as a potential tool to assist clinicians in identifying patients at higher risk for WO and dyskinesia, and may support personalized treatment optimization.

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