Clinical and pharmacological differences in early‐ versus late‐onset Parkinson's disease
Identifieur interne : 005385 ( Main/Exploration ); précédent : 005384; suivant : 005386Clinical and pharmacological differences in early‐ versus late‐onset Parkinson's disease
Auteurs : G. Gomez Arevalo [Argentine] ; R. Jorge [Argentine] ; S. Garcia [Argentine] ; O. Scipioni [Argentine] ; Gershanik [Argentine]Source :
- Movement Disorders [ 0885-3185 ] ; 1997-05.
English descriptors
- KwdEn :
- Acute levodopa test, Adult, Age Factors, Age of Onset, Aged, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Early onset, Female, Humans, Levodopa (administration & dosage), Levodopa (adverse effects), Levodopa (therapeutic use), Levodopa therapy, Male, Middle Aged, Movement Disorders (etiology), Parkinson Disease (drug therapy), Parkinson's disease, Retrospective Studies, Severity of Illness Index.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- etiology : Movement Disorders.
- Adult, Age Factors, Age of Onset, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index.
Abstract
We evaluated whether patients with early‐onset Parkinson's disease (EOPD) have a different clinical profile and pharmacological response than those with late‐onset disease (LOPD). We performed a retrospective analysis and an acute pharmacological challenge with L‐Dopa in 34 EOPD (age at onset between 21 and 40 years) and 34 LOPD (onset after age 60) patients. All patients complete a structured questionnaire cross‐checked against mediacal record charts and underwent an acute levodopa test. Most significant differences were in the mode of onset, time to diagnosis, and degree of initial improvement. We did not observe differences with regard to motor fluctuations. The acute levodopa test showed no differences in latency to response onset between groups. However, the magnitude of the response was greater and the duration shorter in EOPD patients. Younger patients had greater reductions in bradykinesia scores, whereas posture/gait symptomatology was less responsive in older patients. The type and severity of dyskinesias also differed significantly between groups. Our findings suggest that central pharmacokinetics, pharmacodynamics, and, possibly, nondopaminergic systems play a role in the age‐related differences observed in Parkinson's disease.
Url:
DOI: 10.1002/mds.870120303
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">We evaluated whether patients with early‐onset Parkinson's disease (EOPD) have a different clinical profile and pharmacological response than those with late‐onset disease (LOPD). We performed a retrospective analysis and an acute pharmacological challenge with L‐Dopa in 34 EOPD (age at onset between 21 and 40 years) and 34 LOPD (onset after age 60) patients. All patients complete a structured questionnaire cross‐checked against mediacal record charts and underwent an acute levodopa test. Most significant differences were in the mode of onset, time to diagnosis, and degree of initial improvement. We did not observe differences with regard to motor fluctuations. The acute levodopa test showed no differences in latency to response onset between groups. However, the magnitude of the response was greater and the duration shorter in EOPD patients. Younger patients had greater reductions in bradykinesia scores, whereas posture/gait symptomatology was less responsive in older patients. The type and severity of dyskinesias also differed significantly between groups. Our findings suggest that central pharmacokinetics, pharmacodynamics, and, possibly, nondopaminergic systems play a role in the age‐related differences observed in Parkinson's disease.</div>
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