Short-term levodopa test assessed by movement time accurately predicts dopaminergic responsiveness in Parkinson's disease

Mov Disord. 1997 Jan;12(1):103-6. doi: 10.1002/mds.870120118.

Abstract

Short-term challenges with dopaminergic agents are used in patients with idiopathic Parkinson's disease (PD) to predict the therapeutic effect of sustained levodopa treatment, but false-negative results often occur. We prospectively evaluated 74 patients with clinically diagnosed IPD and compared the predictive value of a short-term levodopa test assessed by movement time (MT) with the predictive value obtained by the evaluation with the motor examination part of the Unified Parkinson's Disease Rating Scale (UPDRS-ME). The response to long-term levodopa was accurately predicted in 96% of patients by assessing the response to the short-term test with MT and in 80% of cases with UPDRS-ME. Similar predictive values were obtained by separately analyzing 21 de novo patients. The short-term test also accurately predicted the magnitude of improvement with long-term treatment. We conclude that the predictive value for long-term dopaminergic responsiveness may be further enhanced by evaluating the short-term pharmacologic challenges with MT analysis. This is particularly useful to select de novo patients for drug trials with dopaminergic agents.

MeSH terms

  • Aged
  • Antiparkinson Agents* / administration & dosage
  • Drug Administration Schedule
  • Female
  • Humans
  • Levodopa* / administration & dosage
  • Long-Term Care
  • Male
  • Middle Aged
  • Neurologic Examination / drug effects
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Prognosis
  • Psychomotor Performance / drug effects*
  • Psychomotor Performance / physiology
  • Reaction Time / drug effects*
  • Reaction Time / physiology
  • Receptors, Dopamine / drug effects*
  • Receptors, Dopamine / physiology

Substances

  • Antiparkinson Agents
  • Receptors, Dopamine
  • Levodopa