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Study of levodopa response in Parkinson's disease: Observations on rates of motor progression
Author(s) -
Ding Catherine,
Ganesvaran Ganga,
Alty Jane E.,
Clissold Benjamin G.,
McColl Craig D.,
Reardon Katrina A.,
Schiff Mark,
Srikanth Velandai,
Kempster Peter A.
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26497
Subject(s) - levodopa , parkinson's disease , medicine , dementia , motor function , dopaminergic , disease , motor symptoms , central nervous system disease , degenerative disease , physical medicine and rehabilitation , psychology , physical therapy , dopamine
It is important to understand how the rate of motor progression in PD relates to dopaminergic treatment. Methods The methods for this study comprised prospective defined off state measurements of the levodopa response at 3‐year intervals over a mean 13.3‐year period in 34 patients enrolled before treatment initiation. Results Despite worsening of on and off scores, the magnitude of the l ‐dopa short‐duration response is maintained as the disease progresses. A linear mixed‐effects regression analysis of o ff phase motor scores showed a yearly deterioration of 2.3% of the maximum disability score. Greater motor disability at the commencement of treatment was an independent predictor of faster progression. Demented patients had worse motor function than those without dementia ( P = 0.02), and motor deficit appeared to accelerate toward the end of the disease course in patients who had died. Conclusions These observations should inform clinical trial design for drugs with possible neuroprotective properties. © 2016 International Parkinson and Movement Disorder Society