The duration of the motor response to apomorphine boluses is conditioned by the length of a prior infusion in Parkinson's disease.
Identifieur interne : 002552 ( Ncbi/Checkpoint ); précédent : 002551; suivant : 002553The duration of the motor response to apomorphine boluses is conditioned by the length of a prior infusion in Parkinson's disease.
Auteurs : Julia Vaamonde [Espagne] ; José M. Flores ; Roberto Weisser ; Ram N Iba Ez ; José A. ObesoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Apomorphine, Dopamine Agonists.
- drug effects : Motor Activity.
- drug therapy : Parkinson Disease.
- physiopathology : Parkinson Disease.
- Drug Administration Schedule, Humans, Severity of Illness Index, Time Factors.
Abstract
"Pulsatile" administration of levodopa has been invocated a relevant factor for motor fluctuations in Parkinson's disease (PD). We studied dopaminergic sensitivity to apomorphine in 10 parkinsonian patients with motor fluctuations. Patients were tested as follows: the minimal effective dose of apomorphine (MED-1) was administered in the morning to induce an on response. Fifteen minutes after this motor response had disappeared, an apomorphine infusion was initiated and maintained to ensure on periods of three different durations on different days. Infusion lasted for approximately 30, 60 and 90 minutes. Subsequently, the infusion was stopped, and after 15 minutes in the off state, a second bolus of apomorphine (MED-2) was given. The mean infusion doses were 49.2 +/- 5.4, 108.4 +/- 10.3, and 150 +/- 8.2 mg. These elicited on periods of 48.2 +/- 4.1, 110 +/- 4.5, and 195 +/- 3.8 minutes. The MED-2 elicited on responses with a duration of 30 +/- 4.5, 18.4 +/- 3.2, and 11.2 +/- 4.1 minutes. The duration of the on response induced by the apomorphine infusions correlated inversely (P < 0.01) with the on induced by the MED-2 of apomorphine. Our findings indicate that a continuous dopaminergic stimulus may induce pharmacodynamic changes associated with tolerance in PD patients.
DOI: 10.1002/mds.22234
PubMed: 19224589
Affiliations:
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Flores</name></author><author><name sortKey="Weisser, Roberto" sort="Weisser, Roberto" uniqKey="Weisser R" first="Roberto" last="Weisser">Roberto Weisser</name></author><author><name sortKey="Iba Ez, Ram N" sort="Iba Ez, Ram N" uniqKey="Iba Ez R" first="Ram N" last="Iba Ez">Ram N Iba Ez</name></author><author><name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="José A" last="Obeso">José A. 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Obeso</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Apomorphine (administration & dosage)</term><term>Dopamine Agonists (administration & dosage)</term><term>Drug Administration Schedule</term><term>Humans</term><term>Motor Activity (drug effects)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Severity of Illness Index</term><term>Time Factors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Apomorphine</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motor Activity</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Drug Administration Schedule</term><term>Humans</term><term>Severity of Illness Index</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">"Pulsatile" administration of levodopa has been invocated a relevant factor for motor fluctuations in Parkinson's disease (PD). We studied dopaminergic sensitivity to apomorphine in 10 parkinsonian patients with motor fluctuations. Patients were tested as follows: the minimal effective dose of apomorphine (MED-1) was administered in the morning to induce an on response. Fifteen minutes after this motor response had disappeared, an apomorphine infusion was initiated and maintained to ensure on periods of three different durations on different days. Infusion lasted for approximately 30, 60 and 90 minutes. Subsequently, the infusion was stopped, and after 15 minutes in the off state, a second bolus of apomorphine (MED-2) was given. The mean infusion doses were 49.2 +/- 5.4, 108.4 +/- 10.3, and 150 +/- 8.2 mg. These elicited on periods of 48.2 +/- 4.1, 110 +/- 4.5, and 195 +/- 3.8 minutes. The MED-2 elicited on responses with a duration of 30 +/- 4.5, 18.4 +/- 3.2, and 11.2 +/- 4.1 minutes. The duration of the on response induced by the apomorphine infusions correlated inversely (P < 0.01) with the on induced by the MED-2 of apomorphine. Our findings indicate that a continuous dopaminergic stimulus may induce pharmacodynamic changes associated with tolerance in PD patients.</div></front></TEI><affiliations><list><country><li>Espagne</li></country></list><tree><noCountry><name sortKey="Flores, Jose M" sort="Flores, Jose M" uniqKey="Flores J" first="José M" last="Flores">José M. Flores</name><name sortKey="Iba Ez, Ram N" sort="Iba Ez, Ram N" uniqKey="Iba Ez R" first="Ram N" last="Iba Ez">Ram N Iba Ez</name><name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="José A" last="Obeso">José A. 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