Dopaminergic responsiveness of hypokinesia but not of rigidity and tremor is reduced in fluctuating Parkinson's disease
| Autor: | Petr Mečíř, Jan Roth, Robert Jech, Irena Svobodová, Evžen Růžička |
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| Zdroj: | ResearcherID Advances in Behavioral Biology ISBN: 9781461374350 |
| Popis: | Motor fluctuations and dyskinesias (FD) complicate advanced stages of Parkinson’s Disease (PD). Although L-DOPA may play a key role in the development of FD, it is unclear whether motor symptoms remain equally sensitive to dopaminergic therapy in advanced stages of PD. We studied the effects of Apomorphine (APO), a potent dopamine agonist drug. We examined 17 patients without FD (non-FD group) and 19 patients presenting FD (FD group). The patients were examined twice, before and after APO (0.05 mg/kg s.c). Motor status was tested using the Columbia University Rating Scale (CURS). Total CURS score and subscores for tremor, rigidity and hypokinesia were compared between both groups.The duration of L-DOPA therapy was significantly longer in FD than in non-FD group. Before APO, significantly higher CURS scores and subscores were found in FD than in non-FD patients. After APO, in both groups, significant improvements of total CURS scores and subscores were observed. However, hypokinesia remained significantly worse in FD than in non-FD patients whereas rigidity and tremor did not differ between both groups after APO. Our results confirm the notoriously known fact that FD correlate with the duration of L-DOPA treatment in PD patients. More interestingly, it seems that there is a common denominator between FD and reduced dopaminergic responsiveness of hypokinesia in PD. Thus, the difference between the reactivity to APO of tremor and rigidity on one hand and of hypokinesia on the other hand, may reflect modified pathophysiology of main PD symptoms in fluctuating compared to non-fluctuating PD. total score and subscore for hypokinesia were significantly higher in FD than in non-FD patients while subscores for tremor and rigidity did not differ between both patient groups. |
| Databáze: | OpenAIRE |
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