{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:48:50Z","timestamp":1791222530370,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003197","name":"Agenzia Italiana del Farmaco, Ministero della Salute","doi-asserted-by":"publisher","award":["AIFA\u20102016\u201002364714"],"award-info":[{"award-number":["AIFA\u20102016\u201002364714"]}],"id":[{"id":"10.13039\/501100003197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence suggests that female gender represents a risk factor for the development of motor\/nonmotor fluctuations and dyskinesia in Parkinson's disease (PD). So far, no prospective study has analyzed this aspect in relation to the introduction of levodopa treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This prospective multicenter study aims to assess the development of motor\/nonmotor fluctuations and dyskinesia based on gender over a 2\u2010year observation period in PD patients starting levodopa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred and eighty\u2010nine PD patients requiring levodopa at baseline were enrolled at 17 Movement Disorders Centers and followed for 2\u2009years. Gender differences in the development of fluctuations, defined as a score \u22652 in the 19\u2010item Wearing\u2010Off Questionnaire, and dyskinesia, defined by Movement Disorders Society Unified Parkinson's Disease Rating Scale Part IV (MDS\u2010UPDRS\u2010IV) score &gt;0 on item 4.1 were assessed. Baseline predictors of such complications were evaluated by stepwise multivariate logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and sixteen patients (139 men, 77 women) completed the follow\u2010up (M24). By M24, 53,2% of men and 64.9% of women had fluctuations (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.048), whereas 5% of men and 14.3% of women developed dyskinesia (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0185). Multivariate analysis showed that female gender significantly predicted wearing\u2010off (Odds ratio [OR]\u2009=\u20091.930;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0333), whereas older age was a significant protective factor (for 5\u2010year increase: OR\u2009=\u20090.712;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Multivariate analysis showed that gender (OR\u2009=\u20093.405;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0228) and MDS\u2010UPDRS Part III score (for a 5\u2010unit increase: OR\u2009=\u20091.281;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0239) were significant predictors of dyskinesia at M24.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Female gender was the strongest predictor of fluctuations and dyskinesia after 2\u2010year intake of levodopa. This finding could have important implications for the development of gender\u2010oriented therapeutic recommendations in early PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70143","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T06:29:13Z","timestamp":1748500153000},"page":"1774-1783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Gender Is the Main Predictor of Wearing\u2010Off and Dyskinesia in Levodopa\u2010Na\u00efve Patients with Parkinson's Disease"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6217-313X","authenticated-orcid":false,"given":"Maria Teresa","family":"Pellecchia","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana,\u201d Neuroscience Section University of Salerno  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-137X","authenticated-orcid":false,"given":"Marina","family":"Picillo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana,\u201d Neuroscience Section University of Salerno  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Claudia","family":"Russillo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana,\u201d Neuroscience Section University of Salerno  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Amboni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana,\u201d Neuroscience Section University of Salerno  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennarina","family":"Arabia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Institute of Neurology Magna Gr\u00e6cia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6286-1509","authenticated-orcid":false,"given":"Laura","family":"Avanzino","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine (DIMES), Section of Human Physiology University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Canesi","sequence":"additional","affiliation":[{"name":"Neurorehabilitation Unit, Parkinson's Disease and Movement Disorders Center Moriggia\u2010Pelascini Hospital  Como Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Catania","sequence":"additional","affiliation":[{"name":"Medical Genetics and Neurogenetics Unit Fondazione IRCCS Istituto Neurologico \u201cC. 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