Longitudinal study of the levodopa motor response in Parkinson's disease: Relationship between cognitive decline and motor function
Identifieur interne : 002227 ( Main/Exploration ); précédent : 002226; suivant : 002228Longitudinal study of the levodopa motor response in Parkinson's disease: Relationship between cognitive decline and motor function
Auteurs : Jane E. Alty [Australie] ; Benjamin G. Clissold [Australie] ; Craig D. Mccoll [Australie] ; Katrina A. Reardon [Australie] ; Mark Shiff [Australie] ; Peter A. Kempster [Australie]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-12-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Antiparkinson Agents (pharmacology), Antiparkinson Agents (therapeutic use), Cognition Disorders (drug therapy), Cognition Disorders (etiology), Cognitive disorder, Dementia, Dementia (chemically induced), Disability Evaluation, Dyskinesia, Dyskinesias (etiology), Female, Fluctuations, Humans, Levodopa, Levodopa (pharmacology), Levodopa (therapeutic use), Longitudinal Studies, Male, Middle Aged, Motor Activity (drug effects), Nervous system diseases, Parkinson disease, Parkinson's disease, Parkinsonian Disorders (complications), Parkinsonian Disorders (drug therapy), Statistics, Nonparametric, dementia, dyskinesia, levodopa, motor fluctuation.
- MESH :
- chemical , pharmacology : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- chemically induced : Dementia.
- complications : Parkinsonian Disorders.
- drug effects : Motor Activity.
- drug therapy : Cognition Disorders, Parkinsonian Disorders.
- etiology : Cognition Disorders, Dyskinesias.
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Middle Aged, Statistics, Nonparametric.
Abstract
In this prospective study of 34 patients with Parkinson's disease (PD), measurements of the short duration levodopa motor response have been performed every 3 years in defined off states. The mean time from initiation of levodopa treatment was 14.8 years, and 17 patients survived to the latest assessment stage. Off phase motor function worsened at a yearly rate of 2.2% of the maximum disability score. The magnitude of the levodopa response is well preserved as the disease progresses, and patients who developed motor fluctuations maintained better on phase motor function than nonfluctuators (P = 0.01). Ten patients, of whom 5 survive, developed dementia. There was no difference in pretreatment disability or initial levodopa response between demented and nondemented subjects. However, dementia was associated with worse on and off motor disability scores after 11 and 14 years (P < 0.001), and a smaller levodopa response magnitude after 14 years (P = 0.008). The plot of sequential scores shows the association between cognitive decline and accelerating increase in motor disability. This suggests that the advanced phase of PD, when Lewy body pathology involves the cerebral cortex, progresses in an exponential rather than linear fashion. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22800
Affiliations:
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Le document en format XML
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<term>Antiparkinson Agents (therapeutic use)</term>
<term>Cognition Disorders (drug therapy)</term>
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<term>Levodopa (pharmacology)</term>
<term>Levodopa (therapeutic use)</term>
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<front><div type="abstract" xml:lang="en">In this prospective study of 34 patients with Parkinson's disease (PD), measurements of the short duration levodopa motor response have been performed every 3 years in defined off states. The mean time from initiation of levodopa treatment was 14.8 years, and 17 patients survived to the latest assessment stage. Off phase motor function worsened at a yearly rate of 2.2% of the maximum disability score. The magnitude of the levodopa response is well preserved as the disease progresses, and patients who developed motor fluctuations maintained better on phase motor function than nonfluctuators (P = 0.01). Ten patients, of whom 5 survive, developed dementia. There was no difference in pretreatment disability or initial levodopa response between demented and nondemented subjects. However, dementia was associated with worse on and off motor disability scores after 11 and 14 years (P < 0.001), and a smaller levodopa response magnitude after 14 years (P = 0.008). The plot of sequential scores shows the association between cognitive decline and accelerating increase in motor disability. This suggests that the advanced phase of PD, when Lewy body pathology involves the cerebral cortex, progresses in an exponential rather than linear fashion. © 2009 Movement Disorder Society</div>
</front>
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