Levodopa-induced dyskinesias in Parkinson's disease: clinical and pharmacological classification.
Identifieur interne : 004D33 ( PubMed/Checkpoint ); précédent : 004D32; suivant : 004D34Levodopa-induced dyskinesias in Parkinson's disease: clinical and pharmacological classification.
Auteurs : M R Luquin ; O. Scipioni ; J. Vaamonde ; O. Gershanik ; J A ObesoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1992.
English descriptors
- KwdEn :
- Aged, Apomorphine (diagnostic use), Chlorpromazine (administration & dosage), Chlorpromazine (adverse effects), Dopamine Agents (administration & dosage), Dopamine Agents (adverse effects), Dose-Response Relationship, Drug, Dyskinesia, Drug-Induced (classification), Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (drug therapy), Electromyography (drug effects), Female, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Lisuride (diagnostic use), Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (classification), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease, Secondary (chemically induced), Parkinson Disease, Secondary (classification), Parkinson Disease, Secondary (diagnosis), Parkinson Disease, Secondary (drug therapy), Receptors, Dopamine (drug effects), Sulpiride (administration & dosage), Sulpiride (adverse effects).
- MESH :
- chemical , administration & dosage : Chlorpromazine, Dopamine Agents, Sulpiride.
- chemical , adverse effects : Chlorpromazine, Dopamine Agents, Levodopa, Sulpiride.
- chemical , diagnostic use : Apomorphine, Lisuride.
- chemically induced : Parkinson Disease, Secondary.
- classification : Dyskinesia, Drug-Induced, Parkinson Disease, Parkinson Disease, Secondary.
- diagnosis : Dyskinesia, Drug-Induced, Parkinson Disease, Parkinson Disease, Secondary.
- drug effects : Electromyography, Neurologic Examination, Receptors, Dopamine.
- drug therapy : Dyskinesia, Drug-Induced, Parkinson Disease, Parkinson Disease, Secondary.
- chemical , therapeutic use : Levodopa.
- Aged, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged.
Abstract
Levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) may be classified into three main categories: "On" dyskinesias, diphasic dyskinesias (DD), and "off" periods. The study of 168 parkinsonian patients showed that about half (n = 84) showed one pattern of LID only. A combination of two was present in 68, and 16 had the three presentation patterns. A fairly good correlation between type of dyskinesia and presentation pattern was established. Chorea, myoclonus, and dystonic movements occurred during the "on" period. Dystonic postures, particularly affecting the feet, were mainly present in the "off" period, but a few patients had a diphasic presentation. Repetitive stereotyped movements of the lower limbs always corresponded to DD. Acute pharmacological tests using dopamine agonists (subcutaneous apomorphine 3-8 mg; intravenous lisuride 0.1-0.15 mg) and dopamine antagonists (intravenous sulpiride 200-400 mg and intravenous chlorpromazine 25 mg) were performed in 40 patients. Dopamine agonists enhanced "on" dyskinesias and markedly reduced or abolished "off" period dystonia and DD. Dopamine antagonists reduced all types of LID but usually aggravated parkinsonism. These clinical and pharmacological results indicate that LID in PD are a heterogeneous phenomenon difficult to explain on the basis of a single pathophysiological mechanism.
DOI: 10.1002/mds.870070204
PubMed: 1350058
Affiliations:
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pubmed:1350058Le document en format XML
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<affiliation><nlm:affiliation>Department of Neurology, Clinica Universitaria, University of Navarra, Pamplona-Spain.</nlm:affiliation>
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<author><name sortKey="Vaamonde, J" sort="Vaamonde, J" uniqKey="Vaamonde J" first="J" last="Vaamonde">J. Vaamonde</name>
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<author><name sortKey="Gershanik, O" sort="Gershanik, O" uniqKey="Gershanik O" first="O" last="Gershanik">O. Gershanik</name>
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<term>Chlorpromazine (adverse effects)</term>
<term>Dopamine Agents (administration & dosage)</term>
<term>Dopamine Agents (adverse effects)</term>
<term>Dose-Response Relationship, Drug</term>
<term>Dyskinesia, Drug-Induced (classification)</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Dyskinesia, Drug-Induced (drug therapy)</term>
<term>Electromyography (drug effects)</term>
<term>Female</term>
<term>Humans</term>
<term>Levodopa (adverse effects)</term>
<term>Levodopa (therapeutic use)</term>
<term>Lisuride (diagnostic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (classification)</term>
<term>Parkinson Disease (diagnosis)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease, Secondary (chemically induced)</term>
<term>Parkinson Disease, Secondary (classification)</term>
<term>Parkinson Disease, Secondary (diagnosis)</term>
<term>Parkinson Disease, Secondary (drug therapy)</term>
<term>Receptors, Dopamine (drug effects)</term>
<term>Sulpiride (administration & dosage)</term>
<term>Sulpiride (adverse effects)</term>
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<term>Dopamine Agents</term>
<term>Sulpiride</term>
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<term>Dopamine Agents</term>
<term>Levodopa</term>
<term>Sulpiride</term>
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<term>Lisuride</term>
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<keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Dyskinesia, Drug-Induced</term>
<term>Parkinson Disease</term>
<term>Parkinson Disease, Secondary</term>
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<term>Parkinson Disease</term>
<term>Parkinson Disease, Secondary</term>
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<term>Neurologic Examination</term>
<term>Receptors, Dopamine</term>
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<term>Parkinson Disease</term>
<term>Parkinson Disease, Secondary</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Levodopa</term>
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<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Dose-Response Relationship, Drug</term>
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<front><div type="abstract" xml:lang="en">Levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) may be classified into three main categories: "On" dyskinesias, diphasic dyskinesias (DD), and "off" periods. The study of 168 parkinsonian patients showed that about half (n = 84) showed one pattern of LID only. A combination of two was present in 68, and 16 had the three presentation patterns. A fairly good correlation between type of dyskinesia and presentation pattern was established. Chorea, myoclonus, and dystonic movements occurred during the "on" period. Dystonic postures, particularly affecting the feet, were mainly present in the "off" period, but a few patients had a diphasic presentation. Repetitive stereotyped movements of the lower limbs always corresponded to DD. Acute pharmacological tests using dopamine agonists (subcutaneous apomorphine 3-8 mg; intravenous lisuride 0.1-0.15 mg) and dopamine antagonists (intravenous sulpiride 200-400 mg and intravenous chlorpromazine 25 mg) were performed in 40 patients. Dopamine agonists enhanced "on" dyskinesias and markedly reduced or abolished "off" period dystonia and DD. Dopamine antagonists reduced all types of LID but usually aggravated parkinsonism. These clinical and pharmacological results indicate that LID in PD are a heterogeneous phenomenon difficult to explain on the basis of a single pathophysiological mechanism.</div>
</front>
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<Abstract><AbstractText>Levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) may be classified into three main categories: "On" dyskinesias, diphasic dyskinesias (DD), and "off" periods. The study of 168 parkinsonian patients showed that about half (n = 84) showed one pattern of LID only. A combination of two was present in 68, and 16 had the three presentation patterns. A fairly good correlation between type of dyskinesia and presentation pattern was established. Chorea, myoclonus, and dystonic movements occurred during the "on" period. Dystonic postures, particularly affecting the feet, were mainly present in the "off" period, but a few patients had a diphasic presentation. Repetitive stereotyped movements of the lower limbs always corresponded to DD. Acute pharmacological tests using dopamine agonists (subcutaneous apomorphine 3-8 mg; intravenous lisuride 0.1-0.15 mg) and dopamine antagonists (intravenous sulpiride 200-400 mg and intravenous chlorpromazine 25 mg) were performed in 40 patients. Dopamine agonists enhanced "on" dyskinesias and markedly reduced or abolished "off" period dystonia and DD. Dopamine antagonists reduced all types of LID but usually aggravated parkinsonism. These clinical and pharmacological results indicate that LID in PD are a heterogeneous phenomenon difficult to explain on the basis of a single pathophysiological mechanism.</AbstractText>
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<tree><noCountry><name sortKey="Gershanik, O" sort="Gershanik, O" uniqKey="Gershanik O" first="O" last="Gershanik">O. Gershanik</name>
<name sortKey="Luquin, M R" sort="Luquin, M R" uniqKey="Luquin M" first="M R" last="Luquin">M R Luquin</name>
<name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J A" last="Obeso">J A Obeso</name>
<name sortKey="Scipioni, O" sort="Scipioni, O" uniqKey="Scipioni O" first="O" last="Scipioni">O. Scipioni</name>
<name sortKey="Vaamonde, J" sort="Vaamonde, J" uniqKey="Vaamonde J" first="J" last="Vaamonde">J. Vaamonde</name>
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