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Long-term clinical evaluation in patients with Parkinson's disease and early autonomic involvement.
Parkinsonism Relat Disord. 2006 Jun; 12(5):279-83.PR

Abstract

OBJECTIVE

To evaluate in a prospective longitudinal study the evolution of functional disability and the response to dopaminergic therapy in PD patients with and without autonomic involvement.

METHODS

Sixty untreated consecutive patients with PD underwent autonomic cardiovascular function evaluation using the five autonomic tests of Ewing. An integrated index (Autonomic Score=AS), taking in account the results of all subtests, was calculated. Patients were treated with pergolide and bromocriptine during a 5-year follow-up until the level of functional disability was sufficient to warrant the initiation of levodopa therapy.

RESULTS

Results of autonomic testing were compared with those of a group of age-matched healthy subjects. A value of AS>2 was considered as indicative of autonomic failure. Eighteen patients with PD (35%) showed AS>2 (autonomically impaired group=AI), the remaining 33 (65%) had AS<2 (nonautonomically impaired group=non-AI). During the follow-up levodopa was added to the treatment regimen of 10/18 (55%) patients in AI group, and 6/33 (18%) patients in non-AI group (p<.01).

CONCLUSIONS

The increased occurrence of levodopa adjunct in autonomically impaired PD suggests that there is a more rapid deterioration of functional performance in parkinsonian patients with early autonomic involvement.

Authors+Show Affiliations

Department of Neuroscience, University of Pisa, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16549382

Citation

Lucetti, Claudio, et al. "Long-term Clinical Evaluation in Patients With Parkinson's Disease and Early Autonomic Involvement." Parkinsonism & Related Disorders, vol. 12, no. 5, 2006, pp. 279-83.
Lucetti C, Gambaccini G, Del Dotto P, et al. Long-term clinical evaluation in patients with Parkinson's disease and early autonomic involvement. Parkinsonism Relat Disord. 2006;12(5):279-83.
Lucetti, C., Gambaccini, G., Del Dotto, P., Ceravolo, R., Logi, C., Rossi, G., Murri, L., & Bonuccelli, U. (2006). Long-term clinical evaluation in patients with Parkinson's disease and early autonomic involvement. Parkinsonism & Related Disorders, 12(5), 279-83.
Lucetti C, et al. Long-term Clinical Evaluation in Patients With Parkinson's Disease and Early Autonomic Involvement. Parkinsonism Relat Disord. 2006;12(5):279-83. PubMed PMID: 16549382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term clinical evaluation in patients with Parkinson's disease and early autonomic involvement. AU - Lucetti,Claudio, AU - Gambaccini,Gianna, AU - Del Dotto,Paolo, AU - Ceravolo,Roberto, AU - Logi,Chiara, AU - Rossi,Giuseppe, AU - Murri,Luigi, AU - Bonuccelli,Ubaldo, Y1 - 2006/03/23/ PY - 2005/09/29/received PY - 2005/12/23/accepted PY - 2006/3/22/pubmed PY - 2006/8/19/medline PY - 2006/3/22/entrez SP - 279 EP - 83 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 12 IS - 5 N2 - OBJECTIVE: To evaluate in a prospective longitudinal study the evolution of functional disability and the response to dopaminergic therapy in PD patients with and without autonomic involvement. METHODS: Sixty untreated consecutive patients with PD underwent autonomic cardiovascular function evaluation using the five autonomic tests of Ewing. An integrated index (Autonomic Score=AS), taking in account the results of all subtests, was calculated. Patients were treated with pergolide and bromocriptine during a 5-year follow-up until the level of functional disability was sufficient to warrant the initiation of levodopa therapy. RESULTS: Results of autonomic testing were compared with those of a group of age-matched healthy subjects. A value of AS>2 was considered as indicative of autonomic failure. Eighteen patients with PD (35%) showed AS>2 (autonomically impaired group=AI), the remaining 33 (65%) had AS<2 (nonautonomically impaired group=non-AI). During the follow-up levodopa was added to the treatment regimen of 10/18 (55%) patients in AI group, and 6/33 (18%) patients in non-AI group (p<.01). CONCLUSIONS: The increased occurrence of levodopa adjunct in autonomically impaired PD suggests that there is a more rapid deterioration of functional performance in parkinsonian patients with early autonomic involvement. SN - 1353-8020 UR - https://www.unboundmedicine.com/medline/citation/16549382/Long_term_clinical_evaluation_in_patients_with_Parkinson's_disease_and_early_autonomic_involvement_ DB - PRIME DP - Unbound Medicine ER -