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. 2023 Jul 7;9(7):e18081.
doi: 10.1016/j.heliyon.2023.e18081. eCollection 2023 Jul.

Clinical characteristics and reaction to dopaminergic treatment of drug-naïve patients with Parkinson's disease in central China: A cross sectional study

Weiqi Zeng  1   2 , Yukai Wang  1 , Ling Liu  2 , Yi Wu  2 , Yu Xu  2 , Heng Zhai  2 , Xiaoman Yang  2 , Xuebing Cao  2 , Yan Xu  2
Affiliations

Clinical characteristics and reaction to dopaminergic treatment of drug-naïve patients with Parkinson's disease in central China: A cross sectional study

Weiqi Zeng et al. Heliyon. .

Abstract

Background: The symptoms of early Parkinson's disease (PD) are complex and hidden. The aim of this study is to explore and summarize the characteristics of the symptoms of drug naïve patients with PD.

Objectives: and Methods Drug-naïve patients with PD and age-matched healthy controls were recruited from the outpatient clinic of Wuhan Union Hospital. The motor and non-motor symptoms were evaluated for further analysis using Unified Parkinson's Disease Rating Scale (UPDRS) I, II, and III; Sniffin' Sticks Screening 12 test; Mini-Mental State Exam (MMSE); Montreal Cognitive Assessment (MoCA); Hamilton Anxiety Scale (HAMA); and Hamilton Depression Scale (HAMD) scores. The acute levodopa challenge test (ALCT) was adopted to assess the reaction to dopaminergic treatment.

Results: We recruited 80 drug-naïve patients with PD and 40 age-matched healthy controls (HCs). Approximately 53.7% of the patients were females. The mean onset age was 59.96 ± 10.40 years. The mean UPDRS I, II, and III were 2.01 ± 1.90, 6.18 ± 3.68, and 26.13 ± 12.09, respectively. Compared with HCs, PD patients had lower scores in MMSE and MoCA; and higher scores in HAMA and HAMD (p < 0.05). In ALCT, 54 patients showed good responses to levodopa while 26 patients did not. The mean improvement rate of UPDRS III was 34.09% at 120 min.

Conclusion: The motor symptoms of patients with early PD were mild but virous. They also suffered from different non-motor symptoms. In ALCT, about two thirds of patients (54/80) with early PD showed good response to levodopa. Among four aspects of motor symptoms, bradykinesia reacted best to ALCT, while axial symptoms were the worst.

Keywords: Acute levodopa challenge test; Clinical characteristics; Drug-naïve; Parkinson's disease.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. .

Figures

Fig. 1
Fig. 1
Flow diagram of the study. Abbreviations: PD, Parkinson's disease; HCs, healthy controls; UPDRS, Unified Parkinson's Disease Rating Scale; SS-12, Sniffin’ Sticks Screening 12 test; HAMA, Hamilton Anxiety Scale; HAMD, Hamilton Depression Scale; MMSE, Mini-Mental State Exam; MoCA, Montreal Cognitive Assessment; ALCT, acute levodopa challenge test.
Fig. 2
Fig. 2
The clinical data of PD group. (a) The distribution of onset symptoms in PD; (b) The result of SS-12; (c) Scoring rate of MMSE domain; (d) The result of HAMA scale in PD group; (e) Scoring rate of MoCA domain; (f) The anxiety status of PD group; (g) The distribution of HAMA domain; (h) The distribution of HAMD-24 domain.
Fig. 3
Fig. 3
The improvement of PD-related motor symptoms after acute levodopa challenge test. (a, b) The improvement of UPDRS III score and improvement rate of all patients with PD. (c, d) The improvement of UPDRS III score and improvement rate of patients with PD in levodopa good response group. (e, f) The improvement of UPDRS III score and improvement rate of patients with PD in levodopa poor response group.
See this image and copyright information in PMC

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