Chronological View of Peak and Diphasic Dyskinesia, Wearing Off and Freezing of Gait in Parkinson’s Disease

BACKGROUND: 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.