Levodopa-Induced dyskinesia in Latin America: Prevalence and associated clinical factors in the LARGE-PD cohort

BackgroundAlthough levodopa is the gold standard treatment for Parkinson's disease (PD), its chronic use is associated with levodopa-induced dyskinesia (LID), a motor complication that impacts prognosis, quality of life, and treatment costs. Most known LID-associated factors have been identified in European-descendant populations.ObjectivesTo describe the epidemiology of LID in Latin American and Caribbean (LATAM) countries and assess the relevance of known and novel LID-associated factors in this population.MethodsWe conducted a cross-sectional study using data from the Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD). We included PD patients with information on LID status and levodopa use from eight LATAM countries. LID prevalence was calculated overall and by country. Countries were compared on demographic and clinical variables. Logistic regression was used to identify associations with LID.ResultsA total of 3695 PD patients (58.8% male) were included. Overall LID prevalence was 25.4% [95% CI: 24.06-26.87], ranging from 9.3% in Colombia to 45.1% in Puerto Rico. Prevalence increased progressively with longer disease duration. Country comparisons showed that not all known LID-associated factors explained prevalence differences. In logistic regression, fast disease progression was significantly associated with LID (OR: 1.55, 95%CI: 1.16-2.07), while sex was not (OR: 1.02, 95%CI: 0.87-1.18).ConclusionsThis is the largest study on LID epidemiology in LATAM. While some known risk factors remain relevant, others, like sex, do not, underscoring the need for population-specific studies. Future work should integrate environmental, clinical, and genetic data to better understand LID mechanisms.

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Journal
Journal of Parkinson s Disease
Published
2026-04-17
DOI
https://doi.org/10.1177/1877718x261431204
Primary Topic
Parkinson's Disease Mechanisms and Treatments
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article
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article

Levodopa-Induced dyskinesia in Latin America: Prevalence and associated clinical factors in the LARGE-PD cohort

Denise Hack Nicaretta, Gonzálo Arboleda, Jorge Orozco, Vítor Tumas et al.
Journal of Parkinson s Disease
Parkinson's Disease Mechanisms and Treatments
article

Levodopa-Induced dyskinesia in Latin America: Prevalence and associated clinical factors in the LARGE-PD cohort

Denise Hack Nicaretta, Gonzálo Arboleda, Jorge Orozco, Vítor Tumas, Marcela Tela, Juliana dos Santos Duarte, Gustavo Andres da Prat de Magalhaes, Pedro Chaná‐Cuevas, Sarah Camargos, Thiago Peixoto Leal, Bruno Lopes Santos‐Lobato, Marcelo Merello, Mayela Rodríguez‐Violante, Vanderci Borges, Omar Buriticá, Marcelo Kauffman, Ignacio Fernandez Mata, Grace Helena Letro, Patricio Olguı́n, Sarael Alcauter, Sonia Moreno Másmela, Alejandra Medina-Rivera, Daniel Martínez-Ramírez, Cintia Armas, Ana Rosso, Pedro Braga‐Neto, Miguel Inca‐Martinez, César L. Ávila, Ana J. Hernández-Medrano, Koni Mejía-Rojas, Alan O Espinal Martinez, Artur FS Schuh, Darío Sergio Adamec, Elias Fernandez-Toledo, Emily Waldo, Mario Cornejo‐Olivas, Daniel Teixeira-Dos-Santos, David Aguillon, Beatriz Muñoz Ospina, Angel Vinuela, Henry Mauricio Chaparro-Solano, Susana L Peña Martínez, Sergio Alejandro Rodriguez-Quiroga, Francisco Eduardo Cardoso, Alejandra E Ruiz-Contreras, Emilia M Gatto, Natalia Rojas, Carlos Roberto Rieder, María Valentina Müller
article en

Abstract

BackgroundAlthough levodopa is the gold standard treatment for Parkinson's disease (PD), its chronic use is associated with levodopa-induced dyskinesia (LID), a motor complication that impacts prognosis, quality of life, and treatment costs. Most known LID-associated factors have been identified in European-descendant populations.ObjectivesTo describe the epidemiology of LID in Latin American and Caribbean (LATAM) countries and assess the relevance of known and novel LID-associated factors in this population.MethodsWe conducted a cross-sectional study using data from the Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD). We included PD patients with information on LID status and levodopa use from eight LATAM countries. LID prevalence was calculated overall and by country. Countries were compared on demographic and clinical variables. Logistic regression was used to identify associations with LID.ResultsA total of 3695 PD patients (58.8% male) were included. Overall LID prevalence was 25.4% [95% CI: 24.06-26.87], ranging from 9.3% in Colombia to 45.1% in Puerto Rico. Prevalence increased progressively with longer disease duration. Country comparisons showed that not all known LID-associated factors explained prevalence differences. In logistic regression, fast disease progression was significantly associated with LID (OR: 1.55, 95%CI: 1.16-2.07), while sex was not (OR: 1.02, 95%CI: 0.87-1.18).ConclusionsThis is the largest study on LID epidemiology in LATAM. While some known risk factors remain relevant, others, like sex, do not, underscoring the need for population-specific studies. Future work should integrate environmental, clinical, and genetic data to better understand LID mechanisms.

Journal of Parkinson s Disease
Universidade Federal de Minas Gerais (BR), National University of Tucumán (AR), Universidad Autónoma de Guadalajara (MX), Universidade Federal do Rio Grande do Sul (BR), Cleveland Clinic (US), Universidade de Ribeirão Preto (BR), Universidade Federal de Ciências da Saúde de Porto Alegre (BR), Autonomous University of Queretaro (MX), University of Puerto Rico, Medical Sciences Campus (PR), Ponce Health Sciences University (PR), University of Concepción (CL), Universidade de São Paulo (BR), National University of General San Martín (AR), Universidade Federal do Ceará (BR), Universidad Científica del Sur (PE), Cleveland Foundation (US), Atlantic University College (PR), University of Puerto Rico at Ponce (PR), Daniel Alcides Carrión National University (PE), Universidad de Antioquia (CO), Universidad Nacional de Colombia (CO), Cleveland Clinic Lerner College of Medicine (US), Hospital Universitário Gaffrée e Guinle (BR), Hospital Fernández (AR), Hospital de Magalhães Lemos (PT), Hospital de Clínicas de Porto Alegre (BR), Fundación Valle del Lili (CO), Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (AR), Hospital Ramos Mejía (AR), Instituto de Neurología Cognitiva (AR), Production Development Corporation (CL), Hospital Regional de Concepción (CL), Gobierno de Chile (CL), Instituto Nacional de Enfermedades Neoplásicas (PE), Centro Científico Tecnológico - Tucumán (AR), Hospital e Maternidade Celso Pierro (BR), Hospital das Clínicas da Universidade Federal de Minas Gerais (BR), Instituto de Neurociencia Biomédica (CL), Escuela Argentina de Negocios (AR), Hospital de Niños de la Santísima Trinidad (AR), Hospital Posadas (AR), Instituto de Neurología de Buenos Aires (AR), Instituto Nacional de Neurología y Neurocirugía (MX), University of Bío-Bío (CL), Universidad Dr. Andrés Bello (SV), Instituto Geofísico del Perú (PE), Universidade Federal do Pará (BR), Icesi University (CO), Pontifícia Universidade Católica de Campinas (BR), Universidade Federal do Estado do Rio de Janeiro (BR), Universidade Federal de São Paulo (BR), Universidad Nacional Autónoma de México (MX), Tecnológico de Monterrey (MX)
Michael J. Fox Foundation for Parkinson's Research, American Parkinson Disease Association, Parkinson's Foundation, Consejo Nacional de Ciencia y Tecnología, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Universidad Nacional de Tucumán, National Institutes of Health
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Openalex Percentile: Top 13%
Parkinson's Disease Mechanisms and Treatments
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