Serveur d'exploration sur la maladie de Parkinson

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Clinical and pharmacological differences in early‐ versus late‐onset Parkinson's disease

Identifieur interne : 002049 ( Main/Exploration ); précédent : 002048; suivant : 002050

Clinical 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 :

RBID : ISTEX:A86E2C1CED791B14CE040FEFBF97A56A2D3469F8

English descriptors

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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<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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