Henrique Ballalai Ferraz

PubMed2025

Levodopa-induced dyskinesia is still a major clinical problem in Brazilian movement disorder clinics.

Levodopa-induced dyskinesia (LID) remains a significant motor complication in Parkinson's disease (PD), although opinions differ on its clinical relevance.To explore the current prevalence and impact of LID, we analyzed two cohorts from the Latin American Research Consortium on the Genetics of Parkinson's Disease from movement disorder clinics in the city of São Paulo, Brazil, recruited 10 years apart.The cohorts included 187 individuals diagnosed with PD in phase 1 (2007-2014) and 224 in phase 2 (2021-2022). The presence and functional impact of LID were measured using part IV (items 4.1 and 4.2 respectively) of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).The analysis revealed that LID frequency increased from 34.7 in phase 1 to 54.9% in phase 2 (more recent), with functional impact rising from 25.1 to 38.8%.The findings suggest that LID remains a relevant clinical issue in clinics specialized in movement disorders in Brazil, with no reduction in prevalence throughout the last decade. Further studies from other regions and less specialized neurology centers may help understand this motor complication in Brazil and in other developing countries.

Humans↗

PubMed2025

Modifiable risk factors associated with the risk of developing Parkinson's disease: a critical review.

The etiology of Parkinson's disease (PD) is complex and multifactorial, depending on interactions involving environmental/lifestyle and genetic factors. The genetic aspects of the disease are becoming well characterized, while the environmental factors still need further investigation. In the present narrative review, we have described the most concrete evidence of associations between environmental factors and the risk of developing PD. Physical activity, healthy dietary patterns, smoking, and caffeine intake are protective factors against PD. Head trauma, consumption of milk and dairy products, and pesticide exposure were associated with a higher risk of developing PD. The associations of alcohol consumption, living in rural areas, farming, and consumption of well water with PD are still controversial. Results of several studies strongly suggest that diabetes mellitus is a risk factor for the development of PD, as well as the pre-diabetic state. Lower serum levels of uric acid were associated with an increased risk of developing PD and with worse clinical features and faster progression of symptoms. The protective effects of nonsteroidal antiinflammatory drugs use are controversial. Several other factors were potentially associated with the risk of developing PD: environmental pollutants such as organic solvents, exposure to sunlight, vitamin D deficiency, bullous pemphigoid, bipolar disorder, inflammatory bowel disease, irritable bowel syndrome, certain infections and agents, and essential tremor. Environmental factors are important risk markers for the development of PD. Understanding these risks and protective factors could lead to the implementation of risk-modifying actions for PD.

Humans↗