Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?

Jean François Daneault, Benoit Carignan, Abbas F. Sadikot, Michel Panisset, Christian Duval

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management.Discussion: The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed.Summary: Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.

Original languageEnglish (US)
Article number76
JournalBMC Medicine
Volume11
Issue number1
DOIs
StatePublished - Mar 20 2013

All Science Journal Classification (ASJC) codes

  • General Medicine

Keywords

  • Algorithm
  • DBS
  • DID
  • Deep brain stimulation
  • LID
  • Levodopa
  • Motor complication
  • Motor fluctuations
  • Quality of life
  • Treatment

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