Dopaminergic treatment is associated with decreased body weight in patients with Parkinson's disease and dyskinesias

Eur J Neurol. 2009 Aug;16(8):895-901. doi: 10.1111/j.1468-1331.2009.02617.x. Epub 2009 Apr 3.

Abstract

Background and purpose: Several studies suggested that patients with advanced Parkinson's disease (PD) showed a too low body weight when compared with age-matched, healthy subjects. We aimed to investigate whether PD patients with dyskinesias display body weight alterations and to observe any correlations between medication and other putative determinants.

Methods: Charts of 166 PD patients with fluctuations and dyskinesias, admitted within 6 months to a German movement disorders clinic, were investigated for body mass index (BMI), age at onset, disease duration, Unified Parkinson's Disease Rating Scale motor score, eating coordination and medication.

Results: Analysis showed that 4.2% of PD patients were underweight (BMI < 18.5 kg/m(2)), 46.4% were normal (BMI > 18.5-25 kg/m(2)), 33.7% were overweight (BMI > 25-30 kg/m(2)), 15.7% were obese (BMI > 30 kg/m(2)). Daily levodopa dosage per kg and total dopaminergic dosage per kg body weight were negatively correlated with BMI. Overall, patients' BMI had not significantly changed within 2 years of follow-up.

Conclusions: In sum, advanced PD patients showed a reduced BMI when compared with a control population obtained from an age-matched group taken from a survey of the German Federal Office for Statistics. Our findings indicate that patients with a lower BMI received a higher cumulative levodopa dosage and that levodopa may be responsible for weight loss in PD.

MeSH terms

  • Age of Onset
  • Aged
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Body Mass Index
  • Body Weight / drug effects
  • Dopamine Agents / administration & dosage
  • Dopamine Agents / adverse effects
  • Dopamine Agents / therapeutic use*
  • Dyskinesias / drug therapy*
  • Dyskinesias / physiopathology
  • Eating / drug effects
  • Female
  • Follow-Up Studies
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects
  • Levodopa / therapeutic use*
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Psychomotor Performance / drug effects
  • Severity of Illness Index
  • Time Factors
  • Weight Loss / drug effects*

Substances

  • Antiparkinson Agents
  • Dopamine Agents
  • Levodopa