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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.MD

Abstract

Thirty-four patients with Parkinson's disease were followed for a mean period of 8 years from the time of initiation of levodopa medication. Levodopa response was charted from the starting point of pharmacological treatment to give a longitudinal point of view of the changes that evolve as the disease progresses. Objective measurements of the motor response to levodopa test-doses were made at approximately three yearly intervals. Motor fluctuations developed in 58% of the patient group after a mean treatment period of 35 months. Dyskinesia developed in parallel with fluctuations but appeared on average 7 months before symptomatic wearing-off effects of levodopa doses. The patients with motor fluctuations had significantly better responses to levodopa. By contrast, nonfluctuators were more prone to develop increasing midline motor disability affecting speech, gait and balance. Comparison of test-dose and pretreatment scores suggested that a substantial long-duration response to levodopa remains after many years of treatment, and that lateralized motor deficits show a stronger long duration response than midline ones. Motor fluctuations are a consequence of disease progression but their early development is, on balance, associated with better long-term functional ability because these patients have the greater capacity to respond to pharmacological treatment.

Authors+Show Affiliations

Neurosciences Department, Monash Medical Centre, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12465061

Citation

McColl, Craig D., et al. "Motor Response to Levodopa and the Evolution of Motor Fluctuations in the First Decade of Treatment of Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 17, no. 6, 2002, pp. 1227-34.
McColl CD, Reardon KA, Shiff M, et al. Motor response to levodopa and the evolution of motor fluctuations in the first decade of treatment of Parkinson's disease. Mov Disord. 2002;17(6):1227-34.
McColl, C. D., Reardon, K. A., Shiff, M., & Kempster, P. A. (2002). Motor response to levodopa and the evolution of motor fluctuations in the first decade of treatment of Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 17(6), 1227-34.
McColl CD, et al. Motor Response to Levodopa and the Evolution of Motor Fluctuations in the First Decade of Treatment of Parkinson's Disease. Mov Disord. 2002;17(6):1227-34. PubMed PMID: 12465061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Motor response to levodopa and the evolution of motor fluctuations in the first decade of treatment of Parkinson's disease. AU - McColl,Craig D, AU - Reardon,Katrina A, AU - Shiff,Mark, AU - Kempster,Peter A, PY - 2002/12/5/pubmed PY - 2003/3/26/medline PY - 2002/12/5/entrez SP - 1227 EP - 34 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 17 IS - 6 N2 - Thirty-four patients with Parkinson's disease were followed for a mean period of 8 years from the time of initiation of levodopa medication. Levodopa response was charted from the starting point of pharmacological treatment to give a longitudinal point of view of the changes that evolve as the disease progresses. Objective measurements of the motor response to levodopa test-doses were made at approximately three yearly intervals. Motor fluctuations developed in 58% of the patient group after a mean treatment period of 35 months. Dyskinesia developed in parallel with fluctuations but appeared on average 7 months before symptomatic wearing-off effects of levodopa doses. The patients with motor fluctuations had significantly better responses to levodopa. By contrast, nonfluctuators were more prone to develop increasing midline motor disability affecting speech, gait and balance. Comparison of test-dose and pretreatment scores suggested that a substantial long-duration response to levodopa remains after many years of treatment, and that lateralized motor deficits show a stronger long duration response than midline ones. Motor fluctuations are a consequence of disease progression but their early development is, on balance, associated with better long-term functional ability because these patients have the greater capacity to respond to pharmacological treatment. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/12465061/Motor_response_to_levodopa_and_the_evolution_of_motor_fluctuations_in_the_first_decade_of_treatment_of_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.10244 DB - PRIME DP - Unbound Medicine ER -