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. 2017 Feb 16;12(2):e0172145.
doi: 10.1371/journal.pone.0172145. eCollection 2017.

Side effects induced by the acute levodopa challenge in Parkinson's Disease and atypical parkinsonisms

Rosario Vasta  1 , Alessandra Nicoletti  1 , Giovanni Mostile  1 , Valeria Dibilio  1 , Giorgia Sciacca  1 , Donatella Contrafatto  1 , Calogero Edoardo Cicero  1 , Loredana Raciti  1 , Antonina Luca  1 , Mario Zappia  1
Affiliations

Side effects induced by the acute levodopa challenge in Parkinson's Disease and atypical parkinsonisms

Rosario Vasta et al. PLoS One. .

Abstract

Introduction: Acute levodopa challenge may be performed to predict levodopa chronic responsiveness. The aim of the study was to investigate frequency of side effects during the acute levodopa challenge in PD and atypical parkinsonisms.

Methods: We enrolled 34 de novo PD patients and 29 patients affected by atypical parkinsonisms (Multiple System Atrophy, MSA, n = 10; Progressive Supranuclear Palsy, PSP, n = 12 and Corticobasal Degeneration, CBD, n = 7) who underwent an acute levodopa challenge. Side effects occurring during test were recorded.

Results: Side effects were more frequent among atypical parkinsonisms as unique group when compared to PD patients (64.3% versus 23.5%; p-value 0.002) with an adjusted OR of 4.36 (95%CI 1.40-13.5). Each atypical parkinsonisms showed almost double occurrence of side effects (MSA 90%, PSP 41.7% and CBD 57%).

Conclusions: Side effects during acute levodopa challenge may be frequent in atypical parkinsonisms. This information could be useful in order to better prepare the patient for the test. Furthermore, it could represent a useful cue in differential diagnosis with PD.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism—a prospective study. Can J Neurol Sci J Can Sci Neurol. 1991;18: 275–278. - PubMed
    1. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol. 1999;56: 33–39. - PubMed
    1. Hughes AJ, Lees AJ, Stern GM. Challenge tests to predict the dopaminergic response in untreated Parkinson’s disease. Neurology. 1991;41: 1723–1725. - PubMed
    1. Albanese A, Bonuccelli U, Brefel C, Chaudhuri KR, Colosimo C, Eichhorn T, et al. Consensus statement on the role of acute dopaminergic challenge in Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2001;16: 197–201. - PubMed
    1. Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008;71: 670–676. 10.1212/01.wnl.0000324625.00404.15 - DOI - PMC - PubMed