Chronological View of Peak and Diphasic Dyskinesia, Wearing off and Freezing of Gait in Parkinson's Disease

Dyskinesia, wearing off (WO) and freezing of gait (FOG) are troublesome complications degrading quality of life in the course of Parkinson's disease (PD). Objective: This study evaluated the gross chronological trend of 4 motor complications - peak dose dyskinesia (PDSK), diphasic dyskinesia (DDSK), WO and FOG in a large PD population with stratification by age at disease onset according to the PD duration. Methods: The motor complications of 1212 Korean PD patients were analyzed using Kaplan-Meier curves and Cox proportional hazards models. Results: PDSK and WO appeared first as motor complications and showed accelerated development around the 5 year-PD-duration, while DDSK showed a rather constant development over time and FOG developed around the 10 year-disease duration at an accelerated rate (p<0.001). A younger age at PD onset predicted an earlier appearance of PDSK, DDSK and WO (p<0.001), while an older age at onset (≥60 years) was a predictor for FOG (p=0.014). Conclusion: Motor complications developed with a distinguishing inclination over the PD duration. This study provides insight into the chronological trend of motor complications in PD at a glance.