Clinical Management of Drug-Induced Dyskinesia in Parkinson’s Disease: Why Current Approaches May Need to Be Changed to Optimise Quality of Life

*Jean-Francois Daneault,1 Gloria Vergara-Diaz,1,2 Sunghoon Ivan Lee1,3

1. Motion Analysis Laboratory, Spaulding Rehabilitation Hospital; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
2. Escuela Internacional de Doctorado, Universidad de Sevilla, Sevilla, Spain
3. Advanced Human & Health Analytics Laboratory, College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
*Correspondence to jf.daneault@gmail.com

Disclosure: Jean-Francois Daneault is supported by a fellowship from the Canadian Institutes of Health Research and has a research grant from the Michael J. Fox Foundation. Jean-Francois Daneault also has shares in NeuroMotrix. Gloria Vergara-Diaz is supported by a fellowship from the Alfonso Martin Escudero Foundation (Spain).
Received: 01.04.16 Accepted: 30.09.16
Citation: EMJ. 2016;1[4]:62-69.

Abstract

Parkinson’s disease is a complex, progressive neurodegenerative disorder associated with both motor and non-motor symptoms. Current treatment strategies mainly target the alleviation of motor symptoms through dopaminergic replacement therapy. Many patients with Parkinson’s disease will eventually experience motor complications associated with their anti-parkinsonian medication. One of those complications is drug-induced dyskinesia. This paper firstly reviews current approaches to the management of drug-induced dyskinesia, from modifications to the titration of medication, to more invasive approaches like deep brain stimulation. Following this we describe a recent proposal suggesting that the treatment of dyskinesia should be based on the impact on daily activities of patients rather than on the mere presence of the condition. Next, we discuss how this approach could improve the quality of life of patients and their caregivers and finally, we suggest possible ways of implementing this approach in practice.

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