Occurrence of Motor Complications and Gait Problems After Introduction of Medical Treatment in Parkinson's Disease.

Background: Although patients with Parkinson's disease eventually experience motor complications and gait problems including falls, introducing the necessity for gait assistance, or freezing of gait, there may be a medication dose at which patients do not experience both in the early stage of the disease. Objectives: To identify the medication dose at which Parkinson's disease patients, diagnosed and treated at our hospital, did not experience motor complications and gait problems. Methods: We retrospectively reviewed the clinical course, including motor complications and gait problems, of 119 newly diagnosed patients with Parkinson's disease for 24 months after the introduction of medical treatment. According to the presence of motor complications and/or gait problems, we categorized the patients into Groups 1-3. We estimated the median latency of motor complications or gait problems by Kaplan-Meier survival analysis. We calculated the levodopa equivalent dose. Results: Group 1 contained 25 patients with neither motor complications nor gait problems; Group 2 contained 40 patients who experienced motor complications first with a median latency of 11 months; and Group 3 contained 54 patients who experienced gait problems first with a median latency of 9 months. There were significant differences in the levodopa equivalent dose at 24 months among the groups: 250 mg in Group 1, 300 mg in Group 2, and 225 mg in Group 3. Conclusions: Patients with Parkinson's disease receiving a levodopa equivalent dose between 225 and 300 mg did not experience motor complications and gait problems for 24 months after the introduction of medical treatment.