Evolution of motor fluctuations in Parkinson's disease: A longitudinal study over 6 years

被引:0
作者
Reardon, KA [1 ]
Shiff, M [1 ]
Kempster, PA [1 ]
机构
[1] Monash Med Ctr, Dept Neurosci, Clayton, Vic 3168, Australia
关键词
Parkinson's disease; motor fluctuation; dyskinesia; L-dopa;
D O I
10.1002/1531-8257(199907)14:4<605::AID-MDS1009>3.0.CO;2-H
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
A prospective longitudinal 6-year study of 34 patients with Parkinson's disease from the time of initiation of drug treatment explored changes in the motor response to L-dopa over the early to mid disease course. Motor fluctuations developed in 41% after a mean L-dopa treatment interval of 25 months and dyskinesia developed in 53% after a mean of 15 months' treatment. Patients who developed fluctuations had a significantly better response to L-dopa than nonfluctuators. Nonfluctuators also had significantly greater "midline" motor disability affecting cranial and truncal muscles and gait. The development of motor fluctuations may simply reflect a retained capacity to respond to L-dopa as endogenous dopaminergic neurotransmission declines with progressive nigral cell loss. Many patients who show no sign of motor fluctuation 5 or 6 years into the disease course have a relatively blunted response to L-dopa. The proportion of such cases seems to correspond to the percentage that have coexisting striatal pathologic changes in postmortem studies.
引用
收藏
页码:605 / 611
页数:7
相关论文
共 15 条
  • [1] PERMANENT HUMAN PARKINSONISM DUE TO 1-METHYL-4-PHENYL-1,2,3,6-TETRAHYDROPYRIDINE (MPTP) - 7 CASES
    BALLARD, PA
    TETRUD, JW
    LANGSTON, JW
    [J]. NEUROLOGY, 1985, 35 (07) : 949 - 956
  • [2] DOES LONG-TERM AGGRAVATION OF PARKINSONS-DISEASE RESULT FROM NONDOPAMINERGIC LESIONS
    BONNET, AM
    LORIA, Y
    SAINTHILAIRE, MH
    LHERMITTE, F
    AGID, Y
    [J]. NEUROLOGY, 1987, 37 (09) : 1539 - 1542
  • [3] INDUCTION OF CHOREA AND DYSTONIA IN PARKINSONIAN PRIMATES
    BOYCE, S
    CLARKE, CE
    LUQUIN, R
    PEGGS, D
    ROBERTSON, RG
    MITCHELL, IJ
    SAMBROOK, MA
    CROSSMAN, AR
    [J]. MOVEMENT DISORDERS, 1990, 5 (01) : 3 - 7
  • [4] A METHOD FOR EVALUATING DISABILITY IN PATIENTS WITH PARKINSONS-DISEASE
    CANTER, GJ
    DELATORRE, R
    MIER, M
    [J]. JOURNAL OF NERVOUS AND MENTAL DISEASE, 1961, 133 (02) : 143 - 147
  • [5] MODIFICATION OF PARKINSONISM - CHRONIC TREATMENT WITH L-DOPA
    COTZIAS, GC
    PAPAVASI.PS
    GELLENE, R
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1969, 280 (07) : 337 - &
  • [6] LEVODOPA PHARMACOKINETIC MECHANISMS AND MOTOR FLUCTUATIONS IN PARKINSONS-DISEASE
    FABBRINI, G
    JUNCOS, J
    MOURADIAN, MM
    SERRATI, C
    CHASE, TN
    [J]. ANNALS OF NEUROLOGY, 1987, 21 (04) : 370 - 376
  • [7] FOLSTEIN MF, 1983, ARCH GEN PSYCHIAT, V40, P812
  • [8] MOTOR RESPONSE TO LEVODOPA IN PATIENTS WITH PARKINSONIAN MOTOR FLUCTUATIONS - A FOLLOW-UP-STUDY OVER 3 YEARS
    HUGHES, AJ
    FRANKEL, JP
    KEMPSTER, PA
    STERN, GM
    LEES, AJ
    [J]. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1994, 57 (04) : 430 - 434
  • [9] ACCURACY OF CLINICAL-DIAGNOSIS OF IDIOPATHIC PARKINSONS-DISEASE - A CLINICOPATHOLOGICAL STUDY OF 100 CASES
    HUGHES, AJ
    DANIEL, SE
    KILFORD, L
    LEES, AJ
    [J]. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1992, 55 (03) : 181 - 184
  • [10] LEVODOPA PERIPHERAL PHARMACOKINETICS AND DURATION OF MOTOR RESPONSE IN PARKINSONS-DISEASE
    KEMPSTER, PA
    FRANKEL, JP
    BOVINGDON, M
    WEBSTER, R
    LEES, AJ
    STERN, GM
    [J]. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1989, 52 (06) : 718 - 723