Clinical-pathological study of levodopa complications.
Identifieur interne : 001526 ( PubMed/Corpus ); précédent : 001525; suivant : 001527Clinical-pathological study of levodopa complications.
Auteurs : Azi H. Rajput ; Mark E. Fenton ; Sam Birdi ; Rob Macaulay ; David George ; Bohdar Rozdilsky ; Lee C. Ang ; Ambikaipakan Senthilselvan ; Oleh HornykiewiczSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Brain (drug effects), Brain (pathology), Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Lewy Bodies (drug effects), Lewy Bodies (pathology), Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (pathology), Treatment Outcome.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- diagnosis : Parkinson Disease.
- drug effects : Brain, Lewy Bodies, Neurologic Examination.
- drug therapy : Parkinson Disease.
- pathology : Brain, Lewy Bodies, Parkinson Disease.
- Aged, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
We sought to determine the continued benefit and the pattern of motor complications of long-term levodopa treatment in Parkinson's disease. Patients were evaluated between 1968 and 1996. Only those who had an adequate levodopa trial and in whom autopsy revealed Lewy body Parkinson's disease were included. Total levodopa and mean daily dose were calculated in each case. Dyskinesia, wearing-off and on-off were collectively classified as motor adverse effects and reported as cumulative incidence. Forty-two patients (male, 30; female, 12) with mean 15.9 years of illness and 9.1 years follow-up received on average 500-mg levodopa daily over 9.8 years. Seventeen of 21 patients assessed during the last 18 months of life reported some motor benefit. Adverse effects were seen in 71.4% of patients. The most common was dyskinesia, in 61.9%; wearing-off in 35.7%; and on-off in 16.7% of patients. The earliest adverse effect was dyskinesia and the last to emerge was on-off. Isolated dyskinesia was seen in 35.7% and wearing-off in 7.1% of patients; 15.5% of patients developed dyskinesia after 2.6 years and 31% after 6.4 years on levodopa. We concluded that levodopa benefit declined and adverse effects increased with time. Dyskinesia was the earliest and the most common isolated adverse effect.
PubMed: 11921114
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Fenton</name></author><author><name sortKey="Birdi, Sam" sort="Birdi, Sam" uniqKey="Birdi S" first="Sam" last="Birdi">Sam Birdi</name></author><author><name sortKey="Macaulay, Rob" sort="Macaulay, Rob" uniqKey="Macaulay R" first="Rob" last="Macaulay">Rob Macaulay</name></author><author><name sortKey="George, David" sort="George, David" uniqKey="George D" first="David" last="George">David George</name></author><author><name sortKey="Rozdilsky, Bohdar" sort="Rozdilsky, Bohdar" uniqKey="Rozdilsky B" first="Bohdar" last="Rozdilsky">Bohdar Rozdilsky</name></author><author><name sortKey="Ang, Lee C" sort="Ang, Lee C" uniqKey="Ang L" first="Lee C" last="Ang">Lee C. Ang</name></author><author><name sortKey="Senthilselvan, Ambikaipakan" sort="Senthilselvan, Ambikaipakan" uniqKey="Senthilselvan A" first="Ambikaipakan" last="Senthilselvan">Ambikaipakan Senthilselvan</name></author><author><name sortKey="Hornykiewicz, Oleh" sort="Hornykiewicz, Oleh" uniqKey="Hornykiewicz O" first="Oleh" last="Hornykiewicz">Oleh Hornykiewicz</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:11921114</idno><idno type="pmid">11921114</idno><idno type="wicri:Area/PubMed/Corpus">001526</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001526</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical-pathological study of levodopa complications.</title><author><name sortKey="Rajput, Azi H" sort="Rajput, Azi H" uniqKey="Rajput A" first="Azi H" last="Rajput">Azi H. Rajput</name><affiliation><nlm:affiliation>Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. rajputa@sdh.sk.ca</nlm:affiliation></affiliation></author><author><name sortKey="Fenton, Mark E" sort="Fenton, Mark E" uniqKey="Fenton M" first="Mark E" last="Fenton">Mark E. Fenton</name></author><author><name sortKey="Birdi, Sam" sort="Birdi, Sam" uniqKey="Birdi S" first="Sam" last="Birdi">Sam Birdi</name></author><author><name sortKey="Macaulay, Rob" sort="Macaulay, Rob" uniqKey="Macaulay R" first="Rob" last="Macaulay">Rob Macaulay</name></author><author><name sortKey="George, David" sort="George, David" uniqKey="George D" first="David" last="George">David George</name></author><author><name sortKey="Rozdilsky, Bohdar" sort="Rozdilsky, Bohdar" uniqKey="Rozdilsky B" first="Bohdar" last="Rozdilsky">Bohdar Rozdilsky</name></author><author><name sortKey="Ang, Lee C" sort="Ang, Lee C" uniqKey="Ang L" first="Lee C" last="Ang">Lee C. Ang</name></author><author><name sortKey="Senthilselvan, Ambikaipakan" sort="Senthilselvan, Ambikaipakan" uniqKey="Senthilselvan A" first="Ambikaipakan" last="Senthilselvan">Ambikaipakan Senthilselvan</name></author><author><name sortKey="Hornykiewicz, Oleh" sort="Hornykiewicz, Oleh" uniqKey="Hornykiewicz O" first="Oleh" last="Hornykiewicz">Oleh Hornykiewicz</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Brain (drug effects)</term><term>Brain (pathology)</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Levodopa (therapeutic use)</term><term>Lewy Bodies (drug effects)</term><term>Lewy Bodies (pathology)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (pathology)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Brain</term><term>Lewy Bodies</term><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain</term><term>Lewy Bodies</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We sought to determine the continued benefit and the pattern of motor complications of long-term levodopa treatment in Parkinson's disease. Patients were evaluated between 1968 and 1996. Only those who had an adequate levodopa trial and in whom autopsy revealed Lewy body Parkinson's disease were included. Total levodopa and mean daily dose were calculated in each case. Dyskinesia, wearing-off and on-off were collectively classified as motor adverse effects and reported as cumulative incidence. Forty-two patients (male, 30; female, 12) with mean 15.9 years of illness and 9.1 years follow-up received on average 500-mg levodopa daily over 9.8 years. Seventeen of 21 patients assessed during the last 18 months of life reported some motor benefit. Adverse effects were seen in 71.4% of patients. The most common was dyskinesia, in 61.9%; wearing-off in 35.7%; and on-off in 16.7% of patients. The earliest adverse effect was dyskinesia and the last to emerge was on-off. Isolated dyskinesia was seen in 35.7% and wearing-off in 7.1% of patients; 15.5% of patients developed dyskinesia after 2.6 years and 31% after 6.4 years on levodopa. We concluded that levodopa benefit declined and adverse effects increased with time. Dyskinesia was the earliest and the most common isolated adverse effect.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11921114</PMID><DateCreated><Year>2002</Year><Month>03</Month><Day>28</Day></DateCreated><DateCompleted><Year>2002</Year><Month>05</Month><Day>17</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>17</Volume><Issue>2</Issue><PubDate><Year>2002</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Clinical-pathological study of levodopa complications.</ArticleTitle><Pagination><MedlinePgn>289-96</MedlinePgn></Pagination><Abstract><AbstractText>We sought to determine the continued benefit and the pattern of motor complications of long-term levodopa treatment in Parkinson's disease. Patients were evaluated between 1968 and 1996. Only those who had an adequate levodopa trial and in whom autopsy revealed Lewy body Parkinson's disease were included. Total levodopa and mean daily dose were calculated in each case. Dyskinesia, wearing-off and on-off were collectively classified as motor adverse effects and reported as cumulative incidence. Forty-two patients (male, 30; female, 12) with mean 15.9 years of illness and 9.1 years follow-up received on average 500-mg levodopa daily over 9.8 years. Seventeen of 21 patients assessed during the last 18 months of life reported some motor benefit. Adverse effects were seen in 71.4% of patients. The most common was dyskinesia, in 61.9%; wearing-off in 35.7%; and on-off in 16.7% of patients. The earliest adverse effect was dyskinesia and the last to emerge was on-off. Isolated dyskinesia was seen in 35.7% and wearing-off in 7.1% of patients; 15.5% of patients developed dyskinesia after 2.6 years and 31% after 6.4 years on levodopa. We concluded that levodopa benefit declined and adverse effects increased with time. Dyskinesia was the earliest and the most common isolated adverse effect.</AbstractText><CopyrightInformation>Copyright 2002 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rajput</LastName><ForeName>Azi H</ForeName><Initials>AH</Initials><AffiliationInfo><Affiliation>Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. rajputa@sdh.sk.ca</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fenton</LastName><ForeName>Mark E</ForeName><Initials>ME</Initials></Author><Author ValidYN="Y"><LastName>Birdi</LastName><ForeName>Sam</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Macaulay</LastName><ForeName>Rob</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>George</LastName><ForeName>David</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Rozdilsky</LastName><ForeName>Bohdar</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Ang</LastName><ForeName>Lee C</ForeName><Initials>LC</Initials></Author><Author ValidYN="Y"><LastName>Senthilselvan</LastName><ForeName>Ambikaipakan</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Hornykiewicz</LastName><ForeName>Oleh</ForeName><Initials>O</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000978" MajorTopicYN="N">Antiparkinson Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001921" MajorTopicYN="N">Brain</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004305" MajorTopicYN="N">Dose-Response Relationship, Drug</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007980" MajorTopicYN="N">Levodopa</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016631" MajorTopicYN="N">Lewy Bodies</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009460" 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