Longitudinal study of the motor response to levodopa in Parkinson's disease
- PMID: 17029259
- DOI: 10.1002/mds.21126
Longitudinal study of the motor response to levodopa in Parkinson's disease
Abstract
In this prospective study of 34 patients with Parkinson's disease, measurements of the short duration levodopa motor response have been performed in defined off states at 3 yearly intervals over a mean period of 11.4 years from the point of commencement of levodopa treatment. Twenty-two patients were still available for study; 10 had died and 2 were lost to follow-up. The levodopa motor response amplitude increases over the first 5 years of treatment, and thereafter, on and off scores worsen in parallel with conservation of the response. Patients who developed motor fluctuations within the first 5 years of treatment had, on average, a stronger response to levodopa with significantly better on phase motor function (P = 0.003). Although the proportion of "midline" motor disability (affecting gait, balance, and cranial motor function) increases with time, these deficits do not actually become unresponsive to levodopa. Patients who developed dementia had a significantly more rapid decline in motor function. The latest graph of serial scores for the whole cohort shows an upward curving or exponential increase in motor disability after the first decade of treatment. Applying a notional untreated disability line to this graph--an estimate of the disability that would have accrued if drugs had never been given--we suggest that the long-duration response to levodopa eventually runs down with disease progression.
Copyright 2006 Movement Disorder Society.
Similar articles
-
Motor response to levodopa and the evolution of motor fluctuations in the first decade of treatment of Parkinson's disease.Mov Disord. 2002 Nov;17(6):1227-34. doi: 10.1002/mds.10244. Mov Disord. 2002. PMID: 12465061
-
Longitudinal study of the levodopa motor response in Parkinson's disease: relationship between cognitive decline and motor function.Mov Disord. 2009 Dec 15;24(16):2337-43. doi: 10.1002/mds.22800. Mov Disord. 2009. PMID: 19890972 Clinical Trial.
-
Longitudinal study of levodopa in Parkinson's disease: effects of the advanced disease phase.Mov Disord. 2013 Apr;28(4):476-81. doi: 10.1002/mds.25335. Epub 2013 Feb 6. Mov Disord. 2013. PMID: 23390112
-
When do levodopa motor fluctuations first appear in Parkinson's disease?Eur Neurol. 2010;63(5):257-66. doi: 10.1159/000300647. Epub 2010 Mar 24. Eur Neurol. 2010. PMID: 20332641 Review.
-
Levodopa in the early treatment of Parkinson's disease.Parkinsonism Relat Disord. 2009 Jan;15 Suppl 1:S17-20. doi: 10.1016/S1353-8020(09)70006-9. Parkinsonism Relat Disord. 2009. PMID: 19131036 Review.
Cited by
-
Axial disability and deep brain stimulation in patients with Parkinson disease.Nat Rev Neurol. 2015 Feb;11(2):98-110. doi: 10.1038/nrneurol.2014.252. Epub 2015 Jan 13. Nat Rev Neurol. 2015. PMID: 25582445 Review.
-
Dopaminergic responsiveness and dopaminergic challenge tests of Parkinson's disease: a systematic review and meta-analysis.J Neurol. 2025 Feb 1;272(2):176. doi: 10.1007/s00415-025-12894-8. J Neurol. 2025. PMID: 39891751
-
Unveiling the Impact of Outpatient Physiotherapy on Specific Motor Symptoms in Parkinson's Disease: A Prospective Cohort Study.Brain Neurorehabil. 2023 Oct 16;16(3):e26. doi: 10.12786/bn.2023.16.e26. eCollection 2023 Nov. Brain Neurorehabil. 2023. PMID: 38047098 Free PMC article.
-
Late-stage Parkinson disease.Nat Rev Neurol. 2012 Aug;8(8):435-42. doi: 10.1038/nrneurol.2012.126. Epub 2012 Jul 10. Nat Rev Neurol. 2012. PMID: 22777251 Review.
-
Cortical regulation of striatal medium spiny neuron dendritic remodeling in parkinsonism: modulation of glutamate release reverses dopamine depletion-induced dendritic spine loss.Cereb Cortex. 2010 Oct;20(10):2423-32. doi: 10.1093/cercor/bhp317. Epub 2010 Jan 29. Cereb Cortex. 2010. PMID: 20118184 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical