PMID- 28389156
OWN - NLM
STAT- MEDLINE
DCOM- 20180308
LR  - 20181101
IS  - 1873-5126 (Electronic)
IS  - 1353-8020 (Linking)
VI  - 39
DP  - 2017 Jun
TI  - Response of non-motor symptoms to levodopa in late-stage Parkinson's disease: 
      Results of a levodopa challenge test.
PG  - 37-43
LID - S1353-8020(17)30041-X [pii]
LID - 10.1016/j.parkreldis.2017.02.007 [doi]
AB  - BACKGROUND: Non-motor symptoms (NMS) are extremely common among late-stage 
      Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to 
      decrease with disease progression but its effect on NMS in LSPD still needs to be 
      investigated. OBJECTIVE: To assess the response of blood pressure (BP), pain, 
      fatigue and anxiety to L-dopa in LSPD patients. METHODS: 20 LSPD patients, 
      defined as Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 (MED ON) and 
      22 PD patients treated with subthalamic deep brain stimulation (advanced PD 
      group) underwent an L-dopa challenge. BP and orthostatic hypotension (OH) 
      assessment, a visual analogue scale (VAS) for pain and fatigue and the Strait 
      Trait Anxiety (STAI) were evaluated before and after the L-dopa challenge. 
      RESULTS: Systolic BP dropped significantly after L-dopa intake (p < 0.05) in LSPD 
      patients, while there was no change in pain, fatigue or anxiety. L-dopa 
      significantly improved (p < 0.05) pain and anxiety in the advanced PD group, 
      whereas it had no effect on BP or fatigue. L-dopa-related adverse effects (AEs), 
      namely OH and sleepiness, were more common among LSPD patients. 40% and 65% of 
      LSPD patients were not able to fill out the VAS and the STAI, respectively, while 
      measurement of orthostatic BP was not possible in four LSPD patients. 
      CONCLUSIONS: This exploratory study concludes that some non-motor variables in 
      LSPD do not benefit from the acute action of L-dopa while it can still induce 
      disabling AEs. There is a need for assessment tools of NMS adapted to these 
      disabled LSPD patients.
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Fabbri, Margherita
AU  - Fabbri M
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal.
FAU - Coelho, Miguel
AU  - Coelho M
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal; Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar 
      Lisboa Norte, Lisbon, Portugal.
FAU - Guedes, Leonor Correia
AU  - Guedes LC
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal; Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar 
      Lisboa Norte, Lisbon, Portugal.
FAU - Chendo, Ines
AU  - Chendo I
AD  - Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar Lisboa 
      Norte, Lisbon, Portugal.
FAU - Sousa, Catarina
AU  - Sousa C
AD  - Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, 
      University of Lisbon, Portugal.
FAU - Rosa, Mario M
AU  - Rosa MM
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal; Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar 
      Lisboa Norte, Lisbon, Portugal; Laboratory of Clinical Pharmacology and 
      Therapeutics, Faculty of Medicine, University of Lisbon, Portugal.
FAU - Abreu, Daisy
AU  - Abreu D
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal.
FAU - Costa, Nilza
AU  - Costa N
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal.
FAU - Godinho, Catarina
AU  - Godinho C
AD  - Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, 
      University of Lisbon, Portugal; Center for Interdisciplinary Research Egas Moniz 
      (CiiEM), Instituto Superior de Ciencias da Saude Egas Moniz, Monte de Caparica, 
      Portugal.
FAU - Antonini, Angelo
AU  - Antonini A
AD  - Fondazione Ospedale San Camillo-I.R.C.C.S., Parkinson and Movement Disorders 
      Unit, Venice, Italy; Department of Neurosciences (DNS), Padova University, 
      Padova, Italy.
FAU - Ferreira, Joaquim J
AU  - Ferreira JJ
AD  - Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, 
      Portugal; Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar 
      Lisboa Norte, Lisbon, Portugal; Laboratory of Clinical Pharmacology and 
      Therapeutics, Faculty of Medicine, University of Lisbon, Portugal. Electronic 
      address: joaquimjferreira@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20170207
PL  - England
TA  - Parkinsonism Relat Disord
JT  - Parkinsonism & related disorders
JID - 9513583
RN  - 0 (Antiparkinson Agents)
RN  - 46627O600J (Levodopa)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antiparkinson Agents/*therapeutic use
MH  - Anxiety/*drug therapy/etiology
MH  - Blood Pressure/drug effects
MH  - Cross-Sectional Studies
MH  - Fatigue/*drug therapy/etiology
MH  - Female
MH  - Humans
MH  - Levodopa/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Pain/*drug therapy/etiology
MH  - *Parkinson Disease/complications/drug therapy/psychology
MH  - Psychiatric Status Rating Scales
MH  - Severity of Illness Index
MH  - Visual Analog Scale
OTO - NOTNLM
OT  - Late-stage
OT  - Levodopa
OT  - Non-motor symptoms
OT  - Parkinson's disease
EDAT- 2017/04/09 06:00
MHDA- 2018/03/09 06:00
CRDT- 2017/04/09 06:00
PHST- 2016/11/10 00:00 [received]
PHST- 2017/01/26 00:00 [revised]
PHST- 2017/02/05 00:00 [accepted]
PHST- 2017/04/09 06:00 [pubmed]
PHST- 2018/03/09 06:00 [medline]
PHST- 2017/04/09 06:00 [entrez]
AID - S1353-8020(17)30041-X [pii]
AID - 10.1016/j.parkreldis.2017.02.007 [doi]
PST - ppublish
SO  - Parkinsonism Relat Disord. 2017 Jun;39:37-43. doi: 
      10.1016/j.parkreldis.2017.02.007. Epub 2017 Feb 7.