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- W4310251325 abstract "ABSTRACT Background We recently showed that by employing an enhanced drug‐delivery approach, repeated administration of glial cell line–derived neurotrophic factor (GDNF) can produce a spatially distributed increased 18 F‐DOPA positron emission tomography (PET) uptake, suggesting sprouting of dopaminergic terminals throughout the putamen structure. Despite this, we failed to prove a significant measurable clinical response. Since, however, we have identified a subject demonstrating a temporal relationship between repeated GDNF infusions and dyskinesia arising in the practically defined off (prac off ) state. Objectives To describe the development of prac off dyskinesia across our study population and consider its utility as an indicator that trophic factor–induced terminal sprouting can affect enhanced endogenous dopamine levels. Methods This was a blinded retrospective analysis of videotaped motor assessments at eight weekly study visits. Dyskinesia in the prac off and supramaximal on state were rated using the Clinical Dyskinesia Rating Scale. Logistic regression was employed to explore the predictors of prac off dyskinesia. Generalized estimated equations were used to estimate the cumulative effect of repeated GDNF infusions. Results Mild–moderate choreiform dyskinesia in the prac off state were seen in 47 assessments in 17 (n = 41) subjects. During the 18‐month timeframe, each subsequent 8‐week period of receiving GDNF increased the risk of demonstrating prac off state dyskinesia by 34% (odds ratio [OR], 1.34 (95% confidence interval [CI], 1.20, 1.50); P < 0.001). An increasing supramaximal on dyskinesia score (OR, 1.17 [95% CI, 1.07, 1.30]; P = 0.001) also increased the likelihood of prac off dyskinesia at that visit. Conclusions We report the first description of increasingly prevalent prac off ‐state dyskinesia developing during the course of a trophic factor study. This may provide a surrogate marker that GDNF can enable recovery of endogenous dopamine release even in advanced Parkinson's disease. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society." @default.
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- W4310251325 date "2022-11-29" @default.
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- W4310251325 title "Practically Defined <i>Off</i>‐State Dyskinesia Following Repeated I<scp>ntra</scp>p<scp>utamenal</scp> Glial Cell Line–Derived Neurotrophic Factor Administration" @default.
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- W4310251325 doi "https://doi.org/10.1002/mds.29262" @default.
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