Dyskinesia and the antiparkinsonian response always temporally coincide: a retrospective study.

Abstract:

OBJECTIVE:To clinically characterize the temporal relationship between dyskinesia and the antiparkinsonian response when dyskinesia first emerges during long-term levodopa therapy and to determine if it is consistent with the hypothesized mechanism by which dyskinesia develops. METHODS:Dyskinesia and the antiparkinsonian response to levodopa during 2-hour levodopa infusions were monitored at intervals through the first 4 years of long-term levodopa therapy in 20 subjects with idiopathic Parkinson disease (PD) and previously untreated with levodopa. The onset and offset of the antiparkinsonian response and dyskinesia were compared when dyskinesia first appeared during the 4 years. The findings were compared to 20 subjects with PD on long-term levodopa with dyskinesia and motor fluctuations. RESULTS:The onset and offset of the antiparkinsonian response and dyskinesia generally coincided when dyskinesia first appeared during the 4 years and did not suggest any temporal dissociation of the 2 responses. Further, the latency to the onsets of dyskinesia and the antiparkinsonian response tended to shorten during long-term levodopa therapy, suggesting that both responses were sensitized by long-term levodopa. CONCLUSIONS:The similar onsets and offsets of the antiparkinsonian response and dyskinesia when dyskinesia first appears are not consistent with the postulated progressive decrease in threshold for dyskinesia during long-term levodopa therapy. Other mechanisms for the development of dyskinesia need to be considered.

journal_name

Neurology

journal_title

Neurology

authors

Nutt JG,Chung KA,Holford NH

doi

10.1212/WNL.0b013e3181d90050

subject

Has Abstract

pub_date

2010-04-13 00:00:00

pages

1191-7

issue

15

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e3181d90050

journal_volume

74

pub_type

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