MedWorm: Carbidopa/Levodopa

CARBIDOPA AND LEVODOPAtablet [Physicians Total Care, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 07 Feb 2012 05:00:00 +0100

Updated Date: Feb 7, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Treatment Options for Tauopathies

Current Treatment Options in Neurology — Fri, 03 Feb 2012 17:11:02 +0100

Opinion statement To date, there are no approved and established pharmacologic treatment options for tauopathies, a very heterogenous group of neuropsychiatric diseases often leading to dementia and clinically diagnosed as atypical Parkinson syndromes. Among these so-called Parkinson plus syndromes are progressive supranuclear palsy (PSP), also referred to as Steele-Richardson-Olszewski syndrome; frontotemporal dementia (FTD); and corticobasal degeneration (CBD). Available treatment strategies are based mainly on small clinical trials, miscellaneous case reports, or small case-controlled studies. The results of these studies and conclusions about the efficacy of the medication used are often contradictory. Approved therapeutic agents for Alzheimer´s dementia, such as acet...

Levodopa influences striatal activity but does not affect cortical hyper‐activity in Parkinson’s disease

European Journal of Neuroscience — Fri, 03 Feb 2012 05:00:00 +0100

AbstractMotor studies of Parkinson’s disease (PD) have shown cortical hypo‐activity in relation to nigrostriatal dopamine depletion. Cognitive studies also identified increased cortical activity in PD. We have previously suggested that the hypo‐activity/hyper‐activity patterns observed in PD are related to the striatal contribution. Tasks that recruit the striatum in control participants are associated with cortical hypo‐activity in patients with PD, whereas tasks that do not result in cortical hyper‐activity. The putamen, a structure affected by the neurodegeneration observed in PD, shows increased activation for externally‐triggered (ET) and self‐initiated (SI) movements. The first goal of this study was to evaluate the effect of levodopa on the putamen’s response to ET...

Levodopa: Lees' syndrome: 8 case reports

Reactions — Thu, 02 Feb 2012 18:34:27 +0100

(Source: Reactions)

Levodopa/carbidopa/pramipexole: Dyskinesia in a patient with Segawa disease: case report

Reactions — Thu, 02 Feb 2012 18:34:27 +0100

(Source: Reactions)

Knotting of Percutaneous Endoscopic Jejunostomy Feeding Tubes in Two Patients with Parkinson's Disease and Continuous Duodopa® treatment.

Zeitschrift fur Gastroenterologie — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Krones E, Zollner G, Petritsch W Abstract Continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) via PEJ tubes is increasingly used in patients with advanced stages of Parkinson's disease. Tube-related complications such as kinking or coiling have been frequently reported. We herein describe two cases of tube dysfunction in patients with Parkinson's disease and continuous Duodopa® treatment due to knotting of the distal end of the tube. The mechanisms of knotting are unclear although a causative role of impaired gastrointestinal motility either by Parkinson's disease itself or Duodopa® treatment might be suspected. PMID: 22298101 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Gastroenterologie)

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Progression of Motor and Non‐Motor Features of Parkinson's Disease and Their Response to Treatment

British Journal of Clinical Pharmacology — Sun, 29 Jan 2012 18:20:41 +0100

Conclusions: This analysis indicates tremor progresses more slowly than other cardinal features and that PIGD is less treatment responsive in early PD patients. There was no evidence of baseline PD subtypes as a clinically useful predictor of disease progression rate. Anti‐parkinsonian treatments have symptomatic and disease‐modifying effects on all major features of PD.© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society (Source: British Journal of Clinical Pharmacology)

CARBIDOPA AND LEVODOPAtablet, Extended Release [Global Pharmaceuticals, Division Of Impax Laboratories Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 26 Jan 2012 05:00:00 +0100

Updated Date: Jan 26, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Depomed Announces Initiation of Phase 2 Clinical Study in Parkinson's Disease

Medical News (via PRIMEZONE) — Tue, 24 Jan 2012 21:05:00 +0100

MENLO PARK, Calif., Jan. 24, 2012 (GLOBE NEWSWIRE) -- Depomed, Inc. (Nasdaq:DEPO) today announced that it has initiated a Phase 2 clinical trial of DM-1992, Depomed's novel gastric-retentive, extended-release formulation of carbidopa/levodopa, in patients with advanced Parkinson's disease with motor fluctuations. (Source: Medical News (via PRIMEZONE))

Polyneuropathy while on duodenal levodopa infusion in Parkinson’s disease patients: we must be alert

Journal of Neurology — Tue, 24 Jan 2012 07:27:54 +0100

We describe five PD patients who developed axonal polyneuropathy and vitamin B12 deficiency while on treatment with duodenal levodopa infusion, review other cases reported in the literature, discuss potential etiologic factors, and suggest a possible algorithm for the management and prevention of this complication. One case of Guillain-Barré syndrome and at least 12 cases of polyneuropathy related to vitamin B12 deficiency have been reported in PD patients treated with duodenal levodopa infusion. Levodopa gel infusion may induce a decrease in vitamin B12 levels, leading to peripheral neuropathy. Additional pathogenetic mechanisms include alterations related to the metabolism of l-dopa, abnormal l-dopa absorption, and direct neurotoxicity of l-dopa at high doses. Vitamin B12 supplemen...

Duodenal levodopa/carbidopa infusion therapy in patients with advanced Parkinson’s disease leads to improvement in caregivers’ stress and burden

European Journal of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions: Duodenal levodopa infusion‐related clinical improvement in patients with advanced PD leads to substantial reductions in caregivers’ stress and burden. (Source: European Journal of Neurology)

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Effectiveness of Intensive Inpatient Rehabilitation Treatment on Disease Progression in Parkinsonian Patients: A Randomized Controlled Trial With 1-Year Follow-up

Neurorehabilitation and Neural Repair — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion. These findings suggest that the natural worsening of symptoms associated with PD can be effectively counteracted by a properly designed IRT. (Source: Neurorehabilitation and Neural Repair)

Levodopa/benserazide/carbidopa: Dyskinesia, leading to rhabdomyolysis in an elderly patient: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

Levodopa/carbidopa/pramipexole: Othello syndrome: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

REM sleep behavior disorder in Japanese patients with Parkinson’s disease: a multicenter study using the REM sleep behavior disorder screening questionnaire

Journal of Neurology — Tue, 10 Jan 2012 06:48:22 +0100

Abstract REM sleep behavior disorder (RBD) is known to be observed more frequently in patients with an α-synucleinopathy such as Parkinson’s disease (PD) than in the general population. The precise prevalence of RBD in Japanese PD patients is not known. Therefore, we investigated the prevalence and the clinical characteristics of patients with RBD in a large population of Japanese patients with PD. We investigated various clinical features and employed the Japanese version of the RBD screening questionnaire on 469 non-demented Japanese PD patients in this multicenter study. Probable or possible RBD was detected in 146 patients (31.1%) and was significantly associated with longer PD duration, higher Hoehn and Yahr stage, higher Unified Parkinson’s Disease Rating Scale ...

Efficacy and Safety of Deep Brain Stimulation as an Adjunct to Pharmacotherapy for the Treatment of Parkinson Disease (February).

The Annals of Pharmacotherapy — Tue, 10 Jan 2012 05:00:00 +0100

CONCLUSIONS:DBS may be an option as adjunct therapy in patients whose symptoms are no longer controlled with maximum pharmacologic therapy, but benefits of surgery must be weighed against the risks. PMID: 22234991 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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Contribution of Serotonergic Transmission to the Motor and Cognitive Effects of High-Frequency Stimulation of the Subthalamic Nucleus or Levodopa in Parkinson’s Disease

Molecular Neurobiology — Thu, 05 Jan 2012 17:04:58 +0100

Abstract Although they are effective at treating the motor impairments that are the core symptoms of Parkinson’s disease, current treatments, namely l-3,4-dihydroxyphenylalanine (l-DOPA), the gold standard medication and high-frequency stimulation of the subthalamic nucleus (HFS-STN), can lead to cognitive and mood alterations. Many of these side effects, such as depression, anxiety and sleep disturbances, could be related to abnormal functioning of the serotonergic system, but much basic research remains to be done. Molecular studies in humans and animal models of the disease have reported diverse drastic changes to the serotonergic system. It has also been shown that the serotonergic system both plays a major role in the mechanism of action of the current therapies and ...

What predicts cognitive decline in de novo Parkinson's disease?

Neurobiology of Aging — Thu, 05 Jan 2012 05:00:00 +0100

Authors: Arnaldi D, Campus C, Ferrara M, Famà F, Picco A, De Carli F, Accardo J, Brugnolo A, Sambuceti G, Morbelli S, Nobili F Abstract Subtle cognitive impairment can be detected in early Parkinson's disease (PD). In a consecutive series of de novo, drug-naive PD patients, we applied stepwise regression analysis to assess which clinical, neuropsychological, and functional neuroimaging (dopamine transporter [DAT] and perfusion single photon emission computed tomography [SPECT]) characteristics at baseline was predictive of cognitive decline during an average follow-up time of about 4 years. Decline both in executive (R(2) = 0.54; p = 0.0001) and visuospatial (R(2) = 0.56; p = 0.0001) functions was predicted by the couple of Unified Parkinson's Disease Rating Scale (UPDRS)-III scor...

Trichophagia affects response to duodenal levodopa/carbidopa gel administration

Movement Disorders — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Movement Disorders)

Multichannel microelectrode recording influences final electrode placement in pallidal deep brain stimulation for Parkinson's disease: report of twenty consecutive cases.

Turkish Neurosurgery — Thu, 29 Dec 2011 18:00:03 +0100

CONCLUSION: In our experience intraoperative microelectrode recordings can facilitate final electrode placement. PMID: 22194116 [PubMed - in process] (Source: Turkish Neurosurgery)

PARCOPA (Carbidopa And Levodopa) Tablet, Orally Disintegrating [Azur Pharma Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 27 Dec 2011 05:00:00 +0100

Updated Date: Dec 27, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Chelsea Therapeutics Reports Topline Results From Phase II Trial of Droxidopa in Fibromyalgia

Medical News (via PRIMEZONE) — Thu, 22 Dec 2011 12:30:00 +0100

CHARLOTTE, N.C., Dec. 22, 2011 (GLOBE NEWSWIRE) -- Chelsea Therapeutics International, Ltd. (Nasdaq:CHTP) announced results of a Phase II dose-finding study designed to evaluate the safety and determine the potential therapeutic dose range of droxidopa, alone or in combination with carbidopa, that might be effective for the treatment of fibromyalgia. (Source: Medical News (via PRIMEZONE))

Dopamine agonists for the treatment of cocaine dependence.

Cochrane Database of Systematic Reviews — Tue, 20 Dec 2011 01:00:04 +0100

CONCLUSIONS: Current evidence from randomised controlled trials does not support the use of dopamine agonists for treating cocaine dependence. This absence of evidence may leave to clinicians the alternative of balancing the possible benefits against the potential adverse effects of the treatment. Even the potential benefit of combining a dopamine agonist with a more potent psychosocial intervention which was suggested by the previous Cochrane review (Soares 2003), is not supported by the results of this updated review. PMID: 22161376 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

LODOSYN (Carbidopa) Tablet [Aton Pharma, Inc]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 14 Dec 2011 05:00:00 +0100

Updated Date: Dec 14, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Neuropsychology, neuroimaging or motor phenotype in diagnosis of Parkinson’s disease-dementia: which matters most?

Journal of Neural Transmission — Mon, 12 Dec 2011 17:06:17 +0100

In conclusion, the use of an extensive neuropsychological battery is still recommended in the diagnosis of dementia in PD. Content Type Journal ArticleCategory Movement Disorders - Original ArticlePages 1-8DOI 10.1007/s00702-011-0733-3Authors Francesca Di Biasio, “Sapienza,” University of Rome, Rome, ItalyNicola Vanacore, National Institute of Health (ISS), Rome, ItalyAlfonso Fasano, Gemelli Hospital, Catholic University of Sacred Heart, Rome, ItalyNicola Modugno, Neuromed Institute, “Sapienza,” University of Rome, Rome, ItalyBarbara Gandolfi, Neuromed Institute, “Sapienza,” University of Rome, Rome, ItalyFrancesco Lena, Catholic University of Sacred Heart, Campobasso, ItalyGiovanni Grillea, Neuromed Institute, “Sapienza,” University of Rome, Rome, ItalySara Pietrac...

Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation [Original Contribution]

Archives of Neurology — Mon, 12 Dec 2011 05:00:00 +0100

Conclusion This class III study provides evidence that stimulation-induced motor improvement was sustained overall at 10 years, although part of the initial benefit wore off mainly because of progressive loss of benefit on axial signs over time. (Source: Archives of Neurology)

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Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

Journal of Biomedicine and Biotechnology — Thu, 08 Dec 2011 12:08:51 +0100

We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS) was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided acc...

Sepiapterin reductase deficiency: A treatable mimic of cerebral palsy

Annals of Neurology — Tue, 06 Dec 2011 05:00:00 +0100

We describe clinical, biochemical and molecular findings in a cohort of patients with this treatable condition. We aim to improve awareness of the phenotype and available diagnostic and therapeutic strategies to reduce delayed or misdiagnosis, optimize management and improve understanding of pathophysiologic mechanisms.MethodsForty‐three individuals with SRD were identified from twenty‐three international medical centers. The phenotype and treatment response were assessed by chart review using a detailed standardized instrument and by literature review for cases for which records were unavailable.ResultsIn most cases, motor and language delays, axial hypotonia, dystonia, weakness, oculogyric crises and diurnal fluctuation of symptoms with sleep benefit become evident in infancy or chil...

Intestinal levodopa infusion and COMT inhibition – a promising link

European Journal of Neurology — Mon, 05 Dec 2011 05:00:00 +0100

(Source: European Journal of Neurology)

Cheaper, Simpler, and Better: Tips for Treating Seniors With Parkinson Disease

Mayo Clinic Proceedings — Thu, 01 Dec 2011 05:00:00 +0100

Treatment of seniors with Parkinson disease is within the domain of primary care physicians and internists. A good working knowledge of carbidopa/levodopa principles should allow excellent care of most patients, at least during the early years of the disease. Even later, when levodopa responses become more complicated (eg, dyskinesias, motor fluctuations, insomnia, anxiety), levodopa adjustments may be all that is necessary. A dozen tips for optimizing treatment of Parkinson disease are discussed herein. (Source: Mayo Clinic Proceedings)

Levodopa infusion combined with entacapone or tolcapone in Parkinson disease: a pilot trial

European Journal of Neurology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: According to this small, short‐term pilot study, oral catechol‐O‐methyltransferase inhibitors administered in 5‐h intervals may be useful in cases where levodopa/carbidopa intestinal gel dose reduction is wanted. Stability of plasma levodopa levels is not significantly altered, and off‐time is not increased when decreasing the levodopa/carbidopa intestinal gel dose by 20%. Rather, the dose should probably be decreased more than 20%, especially under tolcapone co‐treatment, to avoid increased dyskinesias with time. (Source: European Journal of Neurology)

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Altered apoptosis regulation in kufor‐rakeb syndrome patients with mutations in the atp13a2 gene

Journal of Cellular and Molecular Medicine — Mon, 28 Nov 2011 05:00:00 +0100

AbstractATP13A2 gene encodes for a protein of the group 5 P‐type ATPase family. ATP13A2 mutations are responsible for Kufor‐Rakeb syndrome, a rare autosomal recessive juvenile parkinsonism characterized by the subacute onset of extrapyramidal, pyramidal and cognitive dysfunction with secondary nonresponsiveness to Levodopa. FBXO7 protein is an F‐box‐containing protein. Recessive FBXO7 mutations are responsible for PARK15, a rare juvenile parkinsonism characterized by progressive neurodegeneration with extrapyramidal and pyramidal system involvement. Our aim was to evaluate apoptosis in cells from two KRS siblings carrying a homozygous ATP13A2 mutation and a heterozygous FBXO7 mutation. We also analysed apoptosis in the patients’ healthy parents. Peripheral blood lymphocytes from ...

Neuropathy in Parkinson disease: Prevalence and determinants

Neurology — Mon, 28 Nov 2011 05:00:00 +0100

Conclusions: Neuropathy is more prevalent in patients with PD than in control subjects. This may be predominantly due to vitamin B12 deficiency, which could relate to cumulative levodopa exposure in susceptible individuals. Vitamin B12 monitoring and supplementation, as well as serial clinical assessment for neuropathy, may be advisable in patients with PD. (Source: Neurology)

Altered apoptosis regulation in kufor-rakeb syndrome patients with mutations in the atp13a2 gene.

J Cell Mol Med — Mon, 28 Nov 2011 05:00:00 +0100

Authors: Radi E, Formichi P, Di Maio G, Battisti C, Federico A Abstract ATP13A2 gene encodes for a protein of the group 5 P-type ATPase family. ATP13A2 mutations are responsible for Kufor-Rakeb syndrome, a rare autosomal recessive juvenile parkinsonism characterized by the subacute onset of extrapyramidal, pyramidal and cognitive dysfunction with secondary nonresponsiveness to Levodopa. FBXO7 protein is an F-box-containing protein. Recessive FBXO7 mutations are responsible for PARK15, a rare juvenile parkinsonism characterized by progressive neurodegeneration with extrapyramidal and pyramidal system involvement. Our aim was to evaluate apoptosis in cells from two KRS siblings carrying a homozygous ATP13A2 mutation and a heterozygous FBXO7 mutation. We also analysed apoptosis in the...

Pramipexole versus dual release levodopa in restless legs syndrome: a double blind, randomised, cross-over trial.

Swiss Medical Weekly — Sat, 26 Nov 2011 19:06:05 +0100

CONCLUSION: This study showed comparable effects of PPX versus dual-release L/B for short-term treatment of de novo patients with mild to moderate RLS. PMID: 22101745 [PubMed - in process] (Source: Swiss Medical Weekly)

Examination of the effect of acute levodopa administration on the loudness dependence of auditory evoked potentials (LDAEP) in humans

Psychopharmacology — Fri, 25 Nov 2011 17:56:32 +0100

Conclusions The administration of levodopa showed no effect on the LDAEP. These findings are in line with other trials using dopamine receptor agonists. Content Type Journal ArticleCategory Original InvestigationPages 1-8DOI 10.1007/s00213-011-2586-8Authors K. Hitz, Department of General Social Psychiatry, University of Zurich, Zurich, SwitzerlandK. Heekeren, Department of General Social Psychiatry, University of Zurich, Zurich, SwitzerlandC. Obermann, Department of General Social Psychiatry, University of Zurich, Zurich, SwitzerlandT. Huber, Internal Medicine, Psychiatric University Hospital Zurich, Zurich, SwitzerlandG. Juckel, Department of Psychiatry, Ruhr-University Bochum, Bochum, GermanyW. Kawohl, Department of General Social Psychiatry, University of Zurich, ...

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Vascular parkinsonism: what makes it different?

Postgraduate Medical Journal — Fri, 25 Nov 2011 05:00:00 +0100

Vascular parkinsonism (VP) accounts for 2.5–5% of all cases of parkinsonism in various population based and clinical cohort studies. VP develops as a result of ischaemic cerebrovascular disease, so aetiologically it is classified as secondary parkinsonism. It has been variably referred to in the literature as arteriosclerotic parkinsonism, vascular pseudo-parkinsonism, and lower body parkinsonism. The most important consideration while making a diagnosis of VP should be to differentiate VP from Parkinson's disease (PD) because of prognostic and therapeutic implications. The salient clinical features in VP which differentiate it from PD are presentation with postural instability and falls rather than with upper limb rest tremor or bradykinesia; short shuffling parkinsonian gait in VP ...

Levodopa/carbidopa/ropinirole/rotigotine: Gambling: case report

Reactions — Tue, 22 Nov 2011 06:51:47 +0100

(Source: Reactions)

Helicobacter pylori eradication for Parkinson's disease.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: There is currently a lack of evidence on the effects of screening and treating H pylori in patients with Parkinson's disease. There is limited evidence to suggest that H Pylori eradication improves the absorption of levodopa and improves motor symptoms. Results from an ongoing trial will inform the evidence base and will be incorporated in an update of this review. There is a need for well-conducted randomised controlled trials with standard outcome measures for motor symptoms and incorporating the costs of screening and treatment. PMID: 22071847 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Pharmacological treatment and the prospect of pharmacogenetics in Parkinson’s disease

International Journal of Clinical Practice — Thu, 17 Nov 2011 17:02:27 +0100

This article is a review of the present pharmacological treatment of PD and current pharmacogenetic data for PD. (Source: International Journal of Clinical Practice)

Helicobacter pylori eradication for Parkinson's disease

NeLM - Disease Focused Reviews — Thu, 17 Nov 2011 05:00:00 +0100

Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Levodopa is the mainstay of treatment for alleviating the motor symptoms associated with Parkinson's disease. However, patients often experience fluctuations in their symptoms over time and 'wearing off' which may be partly related to variable absorption of the drug. There is some evidence that treatment of the common gastrointestinal infection Helicobacter pylori (H pylori) with antibiotics may improve levodopa absorption in the gut and hence improve symptoms. Objectives 1) What is the prevalence of H pylori in Parkinson's disease patients? 2) Does treatment of H pylori infection with antibiotics improve symptoms in Parkinson's disease patients? Is this effect dependent on improve...

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Levodopa Treatment Improves Functional Recovery After Experimental Stroke.

Stroke — Thu, 17 Nov 2011 05:00:00 +0100

CONCLUSIONS: Our results strongly corroborate the concept of recovery enhancing actions of levodopa treatment after stroke. Also, astrocytes in the peri-infarct area may contribute to the dopamine enhanced recovery mechanisms. PMID: 22096034 [PubMed - as supplied by publisher] (Source: Stroke)

CARBIDOPA AND LEVODOPAtablet [Cardinal Health]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 16 Nov 2011 05:00:00 +0100

Updated Date: Nov 16, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Coprescription of Levodopa with Antipsychotics in a Population of 84 596 Psychiatric Inpatients from 1994 to 2008

Pharmacopsychiatry — Tue, 15 Nov 2011 05:00:00 +0100

PharmacopsychiatryDOI: 10.1055/s-0031-1291348Patients on levodopa therapy frequently require additional antipsychotic pharmacotherapy. However, consideration must be given to antagonistic interactions on dopamine receptors between levodopa and antipsychotics, and efficacy and safety of such combinations. We therefore aimed to explore the practice and rationale of coprescription between levodopa and antipsychotics in psychiatric patients.A descriptive retrospective study based on cross-sectional prescription data repeatedly collected from psychiatric inpatients through the international Drug Safety in Psychiatry (AMSP) program between 1994 and 2008 was undertaken.Within a population of 84 596 psychiatric patients the prevalence of levodopa therapy was 1.0% (n=886). Among those patients on...

NeuroDerm Announces Positive Results Of A Phase II Study Of ND0611 Dermal Patch In Patients With Parkinson's Disease

Health News from Medical News Today — Thu, 10 Nov 2011 10:00:00 +0100

NeuroDerm, Ltd. announced today the results of a Phase I/II safety and pharmacokinetic trial of ND0611, administered as an adjunct therapy to Sinemet®, Sinemet® CR or Stalevo®, in patients with advanced Parkinson's disease. ND0611 is a proprietary carbidopa liquid formula administered sub-cutaneously via a dermal patch to increase the bioavailability and efficacy of orally- administered levodopa. Results of this study support the continued development of ND0611 for the treatment of Parkinson's disease... (Source: Health News from Medical News Today)

Do levodopa treatments modify the morphology of the parkinsonian brain?

Movement Disorders — Thu, 10 Nov 2011 05:00:00 +0100

(Source: Movement Disorders)

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Concordance between severity of disease, prevalence of nonmotor symptoms, patient-reported quality of life and disability and use of medication in Parkinson’s disease

Neurological Sciences — Wed, 09 Nov 2011 17:46:20 +0100

In conclusion, we found a substantial concordance between PD staging, prevalence of nonmotor symptoms and patient-reported HRQoL and disability measures. In our opinion, the SF-36 and the WHO-DAS II can be used for profiling patients. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s10072-011-0846-3Authors Alberto Raggi, Neurology, Public Health and Disability Unit–Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation, Via Celoria 11, 20133 Milan, ItalyMatilde Leonardi, Neurology, Public Health and Disability Unit–Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation, Via Celoria 11, 20133 Milan, ItalyVenusia Covelli, Neurology, Public Health and Disability Unit–Scientific Directorate, Neurological Institute C...

Parkinsonism: heterogeneity of a common neurological syndrome.

Swiss Medical Weekly — Wed, 09 Nov 2011 00:15:02 +0100

Authors: Bohlhalter S, Kaegi G Abstract Parkinsonism refers to a neurological syndrome embracing bradykinesia, muscle rigidity, tremor at rest and impaired postural reflexes, and involving a broad differential diagnosis. Having ruled out secondary causes (most importantly drugs), distinguishing levodopa-responsive idiopathic parkinson's disease (PD) from chiefly treatment-resistant and hence atypical parkinsonism is essential. Recent clinico-pathological studies using data-driven approaches have refined the traditional classifications of parkinsonism by identifying a spectrum of subtypes with different prognoses. For example, progressive supranuclear palsy (PSP), characterised by early vertical gaze limitation and falls, probably has a milder variant with predominant parkinsonism (...

Diagnosis and treatment of psychogenic parkinsonism

Journal of Neurology, Neurosurgery and Psychiatry — Mon, 07 Nov 2011 05:00:00 +0100

Parkinson's disease (PD) is the most common movement disorder encountered in movement disorder clinics but psychogenic parkinsonism (PP) is relatively rare. Based on a study of 32 patients, coupled with a comprehensive review of the literature, the diagnosis, clinical phenomenology, epidemiology, natural history, imaging and treatment, this article provides a critical review of PP. In addition to other PD-like symptoms, patients with PP often exhibit abrupt onset, typically in response to a stressful event, followed by a fluctuating course, early disability, bilateral shaking and slowness, non-decremental slowness when performing repetitive movements, voluntary resistance against passive movement without cogwheel rigidity, distractibility, generalised and ‘give-way’ weakness, s...

More Neuropathy in Levodopa-Treated Parkinson's PatientsMore Neuropathy in Levodopa-Treated Parkinson's Patients

Medscape Today Headlines — Fri, 04 Nov 2011 21:31:41 +0100

New data suggest clinical testing would be prudent in patients on long-term therapy. Medscape Medical News (Source: Medscape Today Headlines)

Preservation of function in Parkinson's disease: What's learning got to do with it?

Brain Research — Thu, 03 Nov 2011 02:16:30 +0100

Authors: Beeler JA Abstract Dopamine denervation gives rise to abnormal corticostriatal plasticity; however, its role in the symptoms and progression of Parkinson's disease (PD) has not been articulated or incorporated into current clinical models. The 'integrative selective gain' framework proposed here integrates dopaminergic mechanisms known to modulate basal ganglia throughput into a single conceptual framework: (1) synaptic weights, the neural instantiation of accumulated experience and skill modulated by dopamine-dependent plasticity and (2) system gain, the operating parameters of the basal ganglia, modulated by dopamine's on-line effects on cell excitability, glutamatergic transmission and the balance between facilitatory and inhibitory pathways. Within this framework and b...

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Observational study of sleep-related disorders in Italian patients with Parkinson’s disease: usefulness of the Italian version of Parkinson’s disease sleep scale

Neurological Sciences — Wed, 02 Nov 2011 16:58:12 +0100

Abstract Sleep disturbances are common in patients with Parkinson’s disease (PD). We aimed to evaluate prevalence and severity of nighttime sleep disturbances in Italian PD patients and to validate the Italian version of the Parkinson’s disease sleep scale. A total of 221 PD patients and 57 healthy controls participated in a cross-sectional study with retest. PDSS, Epworth Sleepiness Scale (ESS), Hamilton Depression Rating Scale, Unified Parkinson’s Disease Rating Scale (UPDRS), and Hoehn and Yahr staging were applied. PDSS total and individual items scores from patients were significantly lower than those in controls. Internal consistency of PDSS scale was satisfactory and intraclass correlation coefficient for test–retest reliability was 0.96 for total PDSS score...

Parkinson’s disease

Dental Abstracts — Tue, 01 Nov 2011 04:00:00 +0100

(PD) is an irreversible, slowly progressive, neurodegenerative movement disorder characterized by tremor, rigidity, and bradykinesia. It is a common neurological disease, affecting 120 per 100,000 persons, with men being affected by it 1.5 times more frequently than women. Usually, the onset is after the age of 40 years, and the prevalence increases with increased age, reaching 1% to 5% in persons aged ≥65. The disease reflects the degeneration of dopaminergic neurons in the basal ganglia and substantia nigra of the brain. Patients progress through five stages, with medication being used after the symptoms interfere with the patient’s functioning. Levodopa is the drug of choice, but its effectiveness declines with time. Effects also vary in a 24-hour cycle. Other drugs are commonly us...

CARBIDOPA AND LEVODOPAtablet, Extended Release [Mylan Pharmaceuticals Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 24 Oct 2011 05:00:00 +0100

Updated Date: Oct 24, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Effect of a single dose of standard levodopa on cardiac autonomic function in Parkinson's disease

Neurology India — Sat, 22 Oct 2011 04:00:00 +0100

Conclusion: The results are suggestive of an improvement in the overall variability of the heart rate indicating an enhanced vagal tone. (Source: Neurology India)

Parkinsonism following bilateral hypoxic-ischemic lesions of the striatum

Journal of Neurology — Fri, 21 Oct 2011 06:10:00 +0100

Abstract A 40-year-old white male received cardio-pulmonary resuscitation after cardiac arrest due to an epileptic status. Four months after the incident he developed an akinetic-rigid syndrome and a postural tremor more pronounced on the right side of the body. Brain imaging revealed bilateral lesions of the putamen and caudate nucleus. Levodopa improved bradykinesia and muscular rigidity, but not the postural tremor. Content Type Journal ArticleCategory Original CommunicationPages 1-3DOI 10.1007/s00415-011-6274-8Authors Dennis A. Nowak, Neurologische Fachklinik Kipfenberg, Kindingerstrasse 13, 85110 Kipfenberg, GermanyAndreas Bock, Neurologische Fachklinik Kipfenberg, Kindingerstrasse 13, 85110 Kipfenberg, GermanyMatthias Ponfick, Neurologische Fachklinik Kipfen...

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Nitric Oxide Modulation Of The Basal Ganglia Circuitry: Therapeutic Implication For Parkinson's Disease And Other Motor Disorders.

CNS and Neurological Disorders Drug Targets — Thu, 20 Oct 2011 15:47:42 +0100

Authors: Pierucci M, Galati S, Valentino M, Di Matteo V, Benigno A, Muscat R, Pitruzzella A, Di Giovanni G Abstract Several recent studies have emphasized a crucial role for the nitrergic system in movement control and the pathophysiology of the basal ganglia (BG). These observations are supported by anatomical evidence demonstrating the presence of nitric oxide synthase (NOS) in all the basal ganglia nuclei. In fact, nitrergic terminals have been reported to make synaptic contacts with both substantia nigra dopamine-containing neurons and their terminal areas such as the striatum, the globus pallidus and the subthalamus. These brain areas contain a high expression of nitric oxide (NO)-producing neurons, with the striatum having the greatest number, together with important NO affer...

Tryptophan in Alcoholism Treatment II: Inhibition of the Rat Liver Mitochondrial Low Km Aldehyde Dehydrogenase Activity, Elevation of Blood Acetaldehyde Concentration and Induction of Aversion to Alcohol by Combined Administration of Tryptophan and Benserazide

Alcohol and Alcoholism — Tue, 18 Oct 2011 04:00:00 +0100

Conclusions: The present results establish a prior art for the use of a combination of Trp plus BSZ in the treatment of alcoholism by aversion, which merits rapid clinical development. (Source: Alcohol and Alcoholism)

The default mode network integrity in patients with Parkinson’s disease is levodopa equivalent dose-dependent

Journal of Neural Transmission — Fri, 14 Oct 2011 10:39:30 +0100

We examined the DMN in PD patients on dopaminergic medication with normal cognitive performance compared to age- and gender-matched healthy controls (HC) using fMRI and three methodological procedures: independent component analysis of resting-state data, analysis of deactivation during a complex visual scene-encoding task, and seed-based functional connectivity analysis. In the PD group, we also studied the effect of dopaminergic medication on the DMN integrity. We did not find any difference between the PD and HC groups in the DMN, but using the daily levodopa equivalent dose as a covariate, we observed an enhanced functional connectivity of the DMN in the posterior cingulate cortex and decreased activation in the left parahippocampal gyrus during the cognitive task. We conclude t...

Deep brain stimulation of the subthalamic nucleus for advanced Parkinson disease using general anesthesia: long-term results.

Journal of Neurosurgery — Fri, 14 Oct 2011 04:00:00 +0100

Conclusions Long-term outcomes confirm that it is both safe and effective to perform STN DBS under general anesthesia. As part of patient choice, this option should be offered to all DBS candidates with advanced Parkinson disease to enable more of these patients to undergo this beneficial surgery. PMID: 21999316 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Istradefylline for Parkinson's disease patients experiencing motor fluctuations: Results of the KW-6002-US-018 study

Parkinsonism and Related Disorders — Fri, 14 Oct 2011 04:00:00 +0100

Abstract: Background: Istradefylline (KW-6002) is a selective adenosine A2A receptor antagonist investigated as adjunctive therapy to levodopa in PD patients with motor response complications. In Phase 2b/3 studies, Istradefylline reduced OFF time without worsening troublesome dyskinesia and was well tolerated.Methods: A randomized, 12-week, double-blind, placebo-controlled parallel-group study evaluated the efficacy of 10, 20, and 40 mg/day of Istradefylline in patients on levodopa therapy with motor response complications. The primary outcome measure was change from baseline to endpoint in the percentage of awake time/day spent in the OFF state as determined by patient diary.Results: Six hundred and ten patients were randomized. Five hundred and eighty four patients were included in the...

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Wireless sensors, tablet computer measure Parkinson’s tremors

mobihealthnews — Wed, 12 Oct 2011 17:46:12 +0100

Parkinson’s disease is considered a movement disorder, so it lends itself quite well to mobile technologies. At least one tablet-based device to measure Parkinsonian tremors is already on the market, while an iPhone measurement system passed muster in a clinical trial more than a year ago. Two weeks ago at the AdvaMed 2011 medical technology conference [...] (Source: mobihealthnews)

Levodopa/carbidopa/trospium chloride: Orthostatic hypotension in an elderly patient: case report

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

Automated gait analysis in bilateral Parkinsonian rats and the role of l-DOPA therapy.

Behavioural Brain Research — Wed, 12 Oct 2011 04:00:00 +0100

Authors: Westin JE, Janssen ML, Sager TN, Temel Y Abstract Gait disturbances and postural instability represent major sources of morbidity in Parkinson's disease (PD), and respond poorly to current treatment options. Some aspects of gait disturbances can be observed in rodent models of PD; however, knowledge regarding the stability of rodent gait patterns over time is lacking. Here we investigated the temporal constancy and reproducibility of gait patterns in neurologically intact and bilaterally 6-hydroxydopamine (6-OHDA) lesioned rats, by using an automated quantitative gait analysis method (CatWalk). The bilateral neurotoxin injections into the medial forebrain bundle resulted in an average dopamine (DA) loss of 70% in each striata, which corresponds to the DA levels observed in...

Is levodopa toxic?: Insights from a brain bank

Neurology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: Neurology)

Levodopa toxicity and Parkinson disease: Still a need for equipoise

Neurology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: Neurology)

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Does levodopa accelerate the pathologic process in Parkinson disease brain?

Neurology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusion: Chronic use of l-dopa in PD does not enhance progression of PD pathology as far as can be determined by our observations with SN neuronal counts and LB densities. (Source: Neurology)

Editor's Note: Does levodopa accelerate the pathologic process in Parkinson disease brain?

Neurology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: Neurology)

Deep brain stimulation response in pathologically confirmed cases of multiple system atrophy

Parkinsonism and Related Disorders — Mon, 10 Oct 2011 04:00:00 +0100

This study summarizes the positive and negative effects of deep brain stimulation treatment in two pathologically confirmed multiple system atrophy patients from the University of Florida Deep Brain Stimulation-Brain Tissue Network. Clinical diagnosis for the two patient cases did not match the neuropathological diagnosis. We noted that in both pathologically confirmed multiple system atrophy patients, death occurred as a result of myocardial infarction. Importantly, there was reported transient benefit in levodopa responsive features that indicate deep brain stimulation may be an option for select multiple system atrophy patients. (Source: Parkinsonism and Related Disorders)

A novel nonsense mutation in the TITF-1 gene in a Japanese family with benign hereditary chorea

Journal of the Neurological Sciences — Fri, 07 Oct 2011 04:00:00 +0100

Abstract: A Japanese family with a novel nonsense mutation in the TITF-1 gene (p.Y98X) is described. The proband showed severe generalized chorea, delayed motor development, subnormal intelligence, congenital hypothyroidism, bronchial asthma, and a history of pulmonary infection, all of which are characteristic features of Brain–Thyroid–Lung syndrome. On the other hand, her brother and mother showed a mild benign hereditary chorea (BHC) phenotype with congenital hypothyroidism. Intrafamilial phenotypic variation is common in BHC/Brain–Thyroid–Lung syndrome and suggests the existence of other genetic or environmental factors regulating TITF-1 function. Although choreic movement in BHC/Brain–Thyroid–Lung syndrome is recognized as non-progressive, the proband showed re-exacerbatio...

Feeling of presence in Parkinson's disease

Journal of Neurology, Neurosurgery and Psychiatry — Thu, 06 Oct 2011 04:00:00 +0100

The objective of this study was to provide a detailed description of FP in PD and to discuss its possible mechanisms. Patients and methods The authors studied 52 non-demented PD patients reporting FP in the preceding month (38 consecutive outpatients and 14 inpatients). FP characteristics were recorded with a structured questionnaire. The outpatients with FP were compared with 78 consecutive outpatients without FP. Results About half the patients said they recognised the ‘identity’ of the presence. More than 75% of patients said the FP were not distressing, were short-lasting, were felt beside and/or behind the patient, and occurred while indoors; most patients checked for a real presence, but their insight was generally preserved. In 31% of cases, the patients had an unforme...

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Carbidopa enhances antitumoral activity of bicalutamide on the androgen receptor‐axis in castration‐resistant prostate tumors

The Prostate — Wed, 05 Oct 2011 04:00:00 +0100

CONCLUSIONSThis study demonstrates preclinical proof‐of‐principle that pharmacological targeting of prostate tumors by combination treatment of bicalutamide plus carbidopa significantly reduces AR activity, and thereby delays CRPC tumor progression in vivo. Prostate © 2011 Wiley Periodicals, Inc. (Source: The Prostate)

Levodopa Does Not Accelerate Parkinson's PathologyLevodopa Does Not Accelerate Parkinson's Pathology

Medscape Today Headlines — Tue, 04 Oct 2011 15:01:11 +0100

A new study does not support speculation that levodopa contributes to the neurodegenerative process in Parkinson's disease, but some experts say more study is needed. Medscape Medical News (Source: Medscape Today Headlines)

Mechanisms of initiation and reversal of drug-seeking behavior induced by prenatal exposure to glucocorticoids

Molecular Psychiatry — Tue, 04 Oct 2011 04:00:00 +0100

Authors: A J Rodrigues, P Leão, J M Pêgo, D Cardona, M M Carvalho, M Oliveira, B M Costa, A F Carvalho, P Morgado, D Araújo, J A Palha, O F X Almeida & N Sousa (Source: Molecular Psychiatry)

Levodopa: Dyskinesias: 4 case reports

Reactions — Mon, 03 Oct 2011 06:00:13 +0100

(Source: Reactions)

Poster 68 Effect of Methylphenidate and/or Levodopa Combined with Physiotherapy on Mood and Cognition After Stroke

Archives of Physical Medicine and Rehabilitation — Sat, 01 Oct 2011 04:00:00 +0100

Stimulants can enhance mood and cognition in stroke rehabilitation, but human clinical trial results are inconclusive. We sought to prospectively study the effects of levodopa (LD) and /or methylphenidate (MPH), in combination with physiotherapy on mood and cognition following stroke in human subjects. (Source: Archives of Physical Medicine and Rehabilitation)

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l-DOPA is incorporated into brain proteins of patients treated for Parkinson's disease, inducing toxicity in human neuroblastoma cells in vitro.

Experimental Neurology — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Wang SY, Dunlop RA, Rowe A, Double KL, Rodgers KJ Abstract Levodopa (l-dopa), a close structural analogue of the protein amino acid l-tyrosine, can substitute for l-tyrosine in protein synthesis and be mistakenly incorporated into newly synthesised proteins in vitro. We show that l-dopa-containing proteins are present in the brain in l-DOPA-treated Parkinson's disease patients and accumulate in specific brain regions. In vitro studies demonstrate that substitution of l-tyrosine residues in proteins with l-DOPA causes protein misfolding and promotes protein aggregation in SH-SY5Y neuroblastoma cells resulting in the appearance of autofluorescent bodies. We show that the presence of l-DOPA-containing proteins causes profound changes in mitochondria and stimulates the formati...

Continuing efforts to obtain continuous delivery of levodopa

Movement Disorders — Sat, 01 Oct 2011 04:00:00 +0100

(Source: Movement Disorders)

[Neurology of laughter and humour: pathological laughing and crying].

Revista de Neurologia — Fri, 30 Sep 2011 19:46:01 +0100

CONCLUSIONS. As human neurobiological phenomena, laughter and humour also belong to the field of clinical neurology; their processing is affected in a number of different diseases and, in certain cases, effective treatment can be established. PMID: 21948012 [PubMed - in process] (Source: Revista de Neurologia)

DBS Target Has Differing Effects on GaitDBS Target Has Differing Effects on Gait

Medscape Today Headlines — Wed, 28 Sep 2011 22:48:11 +0100

A study shows that subthalamic stimulation may improve gait more than does pallidal stimulation; continued levodopa therapy is important in both patient groups. Medscape Medical News (Source: Medscape Today Headlines)

Frequency of impulse control behaviours associated with dopaminergic therapy in restless legs syndrome

BMC Neurology — Wed, 28 Sep 2011 04:00:00 +0100

Conclusion: RLS patients treated with dopaminergic agents and dopamine agonists in particular, should be forewarned of potential side effects. A careful history of risk factors should be taken. (Source: BMC Neurology)

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Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Neuropsychopharmacology — Wed, 28 Sep 2011 04:00:00 +0100

Authors: Yoland Smith, Thomas Wichmann, Stewart A Factor & Mahlon R DeLong Keywords: dopamine; movement disorders; neurodegeneration/neuroprotection; neurology; basal ganglia; substantia nigra; deep brain stimulation; nigrostriatal; adenosine (Source: Neuropsychopharmacology)

Camptocormia in Japanese patients with Parkinson's disease: A multicenter study

Movement Disorders — Tue, 27 Sep 2011 04:00:00 +0100

Conclusions:Camptocormia is uncommon in PD and is associated with disease severity, higher L‐dopa dose and higher frequencies of autonomic symptoms. © 2011 Movement Disorder Society (Source: Movement Disorders)

Nonmotor versus motor symptoms: How much do they matter to health status in Parkinson's disease?

Movement Disorders — Tue, 27 Sep 2011 04:00:00 +0100

AbstractEvidence suggests that both motor and nonmotor symptoms contribute to health status in Parkinson's disease. Less clear is how much change in health status can be expected if these clinical variables change. In addition, anxiety, separate from depression, has rarely been examined as a predictor of health status. We used hierarchical multiple regression analysis and standardized beta coefficients in a prevalent cohort of 462 patients with Parkinson's disease to explore the relative impact on health status (measured using the Parkinson's Disease Questionnaire) of 5 well‐recognized symptom domains in Parkinson's disease: motor signs, depression, anxiety, cognition, and other nonmotor symptoms. In the health status scores, 19.6% of variance was explained by age, number of comorbiditie...

Augmentation May Complicate Restless Legs Syndrome Treatment

About Sleep Disorders — Thu, 22 Sep 2011 04:00:00 +0100

Restless legs syndrome can plague your evenings with a disagreeable sensation in your legs that is relieved by movement, and treatment may actually complicate things by introducing a new problem: augmentation. There are many potential causes of restless legs, and treatment options can be effective in offering relief. Medications like Mirapex and Requip are commonly used. Sinemet, sold under the generic name levodopa/carbidopa, is also a helpful agent. However, these medications may lead to a side effect called augmentation. Augmentation describes the phenomenon where, after starting treatment or increasing your medication dose, symptoms move earlier in the day or begin to affect the arms. The symptoms may also become more intense. Fortunately, careful consultation with you doctor may pro...

Controversies in Neurology: Why Monoamine Oxidase B Inhibitors Could Be a Good Choice for the Initial Treatment of Parkinson's Disease

BMC Neurology — Thu, 22 Sep 2011 04:00:00 +0100

DiscussionIn multiple studies, MAO-B inhibitors, such as selegiline and rasagiline, have shown to provide mild symptomatic effects, delay the need for levodopa, and to reduce the incidence of motor fluctuations. Although their symptomatic efficacy is inferior compared to dopamine agonists and levodopa, MAO-B inhibitors undoubtedly have fewer side effects and are easy to administer. In contrary to their competitors, MAO-B inhibitors may furthermore offer a chance for disease modification, which so far remains a major unmet need in the management of PD and eventually makes them ideal candidates for the early treatment of the disease.SummaryMAO-B inhibitors may constitute a preferable therapeutic option for early PD, mainly due to their favourable safety profile and their putative neuroprotec...

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Deep Brain Stimulation for Early‐Stage Parkinson's Disease: An Illustrative Case

Neuromodulation — Wed, 21 Sep 2011 04:00:00 +0100

Conclusions: This report details the first successful application of bilateral STN‐DBS for early‐stage PD during a clinical trial. (Source: Neuromodulation)

Metabolic changes induced by theta burst stimulation of the cerebellum in dyskinetic Parkinson’s disease patients

Parkinsonism and Related Disorders — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: Our study demonstrates the antidyskinetic effect of cerebellar cTBS in Parkinson’s disease patients with levodopa induced dyskinesia, is paralleled by modulation of the activity of the pathways connecting the cerebellar cortex with the deep cerebellar nuclei, confirming the hypothesis that the motor cerebellar circuit is involved in the generations of levodopa induced dyskinesia. (Source: Parkinsonism and Related Disorders)

Higher free d-aspartate and N-methyl-d-aspartate levels prevent striatal depotentiation and anticipate l-DOPA-induced dyskinesia.

Experimental Neurology — Sat, 17 Sep 2011 04:00:00 +0100

In this study, we examined the influence of a basal corticostriatal hyper-glutamatergic transmission in the appearance of dyskinesia, using a genetic mouse model lacking d-Aspartate Oxidase (DDO) enzyme (Ddo(-/-) mice). We found that, in Ddo(-/-) mice, non-physiological, high levels of the endogenous free d-amino acids d-aspartate (d-Asp) and NMDA, known to stimulate NMDAR transmission, resulted in the loss of corticostriatal synaptic depotentiation and precocious expression of LID. Interestingly, the block of depotentiation precedes any change in dopaminergic transmission associated to 6-OHDA lesion and l-DOPA treatment. Indeed, lesioned mutant mice display physiological l-DOPA-dependent enhancement of striatal D1 receptor/PKA/protein phosphatase-1 and ERK signaling. Moreover, in line wit...

The effect of different dosing regimens of levodopa/carbidopa/entacapone on plasma levodopa concentrations

European Journal of Clinical Pharmacology — Fri, 16 Sep 2011 16:49:35 +0100

Conclusions Reducing the dose of LCE by 25 mg following the first morning dose results in a more consistent levodopa Cmax profile, avoiding levodopa accumulation while maintaining significantly higher Cmin levels and AUC0−14 values compared with LC. Content Type Journal ArticleCategory Pharmacokinetics and DispositionPages 1-9DOI 10.1007/s00228-011-1121-5Authors Kimmo Ingman, Phase I Unit, Orion Pharma, Orion Corporation, Espoo, FinlandTarja Naukkarinen, Orion Pharma, Orion Corporation, Turku, FinlandMikko Vahteristo, Orion Pharma, Orion Corporation, Kuopio, FinlandIrja Korpela, Orion Pharma, Orion Corporation, Turku, FinlandMikko Kuoppamäki, Orion Pharma, Orion Corporation, Turku, FinlandJuha Ellmén, Orion Pharma, Orion Corporation, Turku, Finland Jou...

Combined pallidal and subthalamic nucleus stimulation in sporadic dystonia-parkinsonism.

Journal of Neurosurgery — Fri, 16 Sep 2011 04:00:00 +0100

Authors: Wöhrle JC, Blahak C, Capelle HH, Fogel W, Bäzner H, Krauss JK Abstract Multifocal deep brain stimulation (DBS) is a new technique that has been introduced recently. A 39-year-old man with dystonia-parkinsonism underwent the simultaneous implantation of subthalamic nucleus (STN) and globus pallidus internus (GPi) DBS electrodes. While bilateral STN DBS controlled the parkinsonian symptoms well and allowed for a reduction in levodopa, the improvement of dystonia was only temporary. Additional GPi DBS also alleviated dystonic symptoms. Formal assessment at the 1-year follow-up showed that both the parkinsonian symptoms and the dystonia were markedly improved via continuous bilateral combined STN and GPi stimulation. Sustained benefit was achieved at 3 years postoperatively....

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Associated factors for REM sleep behavior disorder in Parkinson disease

Neurology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusion: RBD is a frequent and clinically relevant nocturnal disturbance for all stages of PD. It increases with age and disease duration and may contribute to the nocturnal problems of patients with PD and their bed partners. (Source: Neurology)

Motor improvement with bilateral subthalamic nucleus deep brain stimulation in a patient with levodopa-responsive secondary parkinsonism

Parkinsonism and Related Disorders — Fri, 09 Sep 2011 04:00:00 +0100

We present the case of a woman with secondary parkinsonism that developed following a Measles, Mumps, and Rubella (MMR) vaccination, who experienced sustained improvement in motor function following STN DBS. Despite the diagnosis of a secondary parkinsonism, this patient responded well to dopaminergic therapy, a good predictor of DBS outcome in patients with idiopathic Parkinson’s disease. This case suggests that DBS may be considered in the setting of secondary parkinsonism if such patients have levodopa-responsive symptoms. (Source: Parkinsonism and Related Disorders)

LODOSYN (Carbidopa) Tablet [Bristol-Myers Squibb Pharma Company]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 08 Sep 2011 05:00:00 +0100

Updated Date: Sep 8, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

The natural history of treated PD in an incident, community-based cohort: does the future begin?

Journal of Neurology, Neurosurgery and Psychiatry — Thu, 08 Sep 2011 04:00:00 +0100

Advances in our understanding of the genetics, epidemiology, clinical phenotype and pathological progression of Parkinson's disease (PD) have ushered in an era in which researchers are increasingly looking for therapies that modify (prevent or delay) PD course. Drugs like levodopa, selegiline and rasagiline, which are known to ameliorate the core motor symptoms of PD, have been tested for a possible disease-modifying effect,1–3 and new putative neuroprotective therapies could soon be available. In order to accurately test neuroprotective effects, drugs need to be challenged with markers of disease progression. To date, data from putative biomarkers assessed in body fluids are limited and inconclusive, structural imaging does not add relevant information to our knowledge and imaging t...

Apomorphine infusion in advanced Parkinson’s patients with subthalamic stimulation contraindications

Parkinsonism and Related Disorders — Wed, 07 Sep 2011 04:00:00 +0100

Conclusions: APO is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN-DBS is contraindicated due to dopa-resistant axial motor symptoms and/or cognitive decline. As such, it should be regarded as a viable alternative for these patients. (Source: Parkinsonism and Related Disorders)

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Genetic variant of HTR2A associates with risk of impulse control and repetitive behaviors in Parkinson’s disease

Parkinsonism and Related Disorders — Wed, 07 Sep 2011 04:00:00 +0100

Conclusion: Our data support a possible contribution of genetic variation in the HTR2A to the susceptibility to impulse control and repetitive behaviors in Parkinson’s disease. (Source: Parkinsonism and Related Disorders)

Effect of rasagiline as adjunct therapy to levodopa on severity of OFF in Parkinson’s disease

European Journal of Neurology — Mon, 05 Sep 2011 23:00:00 +0100

Conclusions: This study provides the first objectively measured evidence that adjunct rasagiline 1 mg/day is effective in reducing the severity of motor symptoms in the OFF state. This suggests a continuous effect of rasagiline 1 mg/day throughout the day and night and is consistent with its extended duration of therapeutic action. (Source: European Journal of Neurology)

Association of heart rate variability with clinical outcome in Parkinsonian patients after subthalamic deep brain stimulation: A retrospective cohort study.

J Formos Med Assoc — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSION: Our study showed an improvement in autonomic cardiovascular regulation in Parkinsonian patients with >50% improvement in rating scale after STN-DBS, which implied morbidity reduction in nonmotor symptoms among such patients. PMID: 21930070 [PubMed - in process] (Source: J Formos Med Assoc)

Dopa-responsive Dystonia with a Novel Initiation Codon Mutation in the GCH1 Gene Misdiagnosed as Cerebral Palsy.

J Korean Med Sci — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Lee JH, Ki CS, Kim DS, Cho JW, Park KP, Kim S Abstract Dopa-responsive dystonia (DRD) is a clinical syndrome characterized by childhood-onset dystonia and a dramatic response to relatively low doses of levodopa. However, patients with DRD can be misdiagnosed as cerebral palsy or spastic diplegia due to phenotypic variation. Here we report a young woman with DRD who were severely disabled and misdiagnosed as cerebral palsy for over 10 yr. A small dose of levodopa restored wheelchair-bound state to normality. However, thoracolumbar scoliosis has remained as a sequel due to late detection of DRD. Genetic analysis by using PCR-direct sequencing revealed a novel initiation codon mutation (c.1A>T; p.Met1Leu) in GTP cyclohydrolase 1 (GCH1) gene. Although it is known that DRD c...

The long-duration response to levodopa: Phenomenology, potential mechanisms and clinical implications

Parkinsonism and Related Disorders — Wed, 31 Aug 2011 23:00:00 +0100

Abstract: The antiparkinsonian response to levodopa is characterized by an immediate motor improvement lasting hours and a more sustained response lasting days. These two responses have been referred to as the short-duration response (SDR) and the long-duration response (LDR). The LDR represents a substantial component of the clinical effect of levodopa and has been clinically recognized for several decades, but it remains poorly understood. This review will focus on the LDR phenomenology and theories about its origin, with the goal of promoting inquiry into this important but as yet poorly understood aspect of levodopa therapy for PD. (Source: Parkinsonism and Related Disorders)

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Mechanisms underlying the onset and expression of levodopa-induced dyskinesia and their pharmacological manipulation

Journal of Neural Transmission — Wed, 31 Aug 2011 15:54:33 +0100

Abstract A significant proportion of patients with Parkinson’s disease (PD) receiving dopamine replacement therapy in the form of levodopa develop dyskinesia that becomes a major complicating factor in treatment. Dyskinesia can only be effectively treated by a reduction in drug dose, which limits efficacy, by co-administration of the weak NMDA antagonist amantadine or by surgical treatment (pallidotomy, DBS). This raises the important question of why dyskinesia occurs in PD and how it can be avoided or suppressed by pharmacological treatment. This review assesses some of the mechanisms that underlie dyskinesia induction and expression from presynaptic changes in dopaminergic neurones to postsynaptic alterations in basal ganglia function and examines potential approaches ...

Levodopa/carbidopa: Psychosis in an elderly patient: case report

Reactions — Mon, 29 Aug 2011 14:09:06 +0100

(Source: Reactions)

Levodopa/carbidopa/ropinirole: Dyskinesias: case report

Reactions — Mon, 29 Aug 2011 14:09:06 +0100

(Source: Reactions)

Clinical approach to nonmotor sensory fluctuations in Parkinson's disease

Journal of the Neurological Sciences — Mon, 29 Aug 2011 04:00:00 +0100

Conclusion: Recognition of NMSFs is important in the care of patients with Parkinson disease to prevent unnecessary interventions and for appropriate medication regimen adjustments. (Source: Journal of the Neurological Sciences)

Network correlates of the cognitive response to levodopa in Parkinson disease

Neurology — Sun, 28 Aug 2011 23:00:00 +0100

Conclusions: These findings suggest that cognitive dysfunction in PD may respond to treatment depending upon the degree of baseline PDCP expression. Quantification of treatment-mediated network changes can provide objective information concerning the efficacy of new agents directed at the cognitive manifestations of this disease. (Source: Neurology)

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Levodopa: Serotonin syndrome: case report

Reactions — Sat, 27 Aug 2011 15:26:04 +0100

(Source: Reactions)

An Autoradiographic Study on the Pathogenesis of Levodopa-Induced Dyskinesia: Regulation of Dopamine Transporter by Levodopa in a Rat Model of Parkinson's Disease.

Neuro-Degenerative Diseases — Thu, 25 Aug 2011 23:00:00 +0100

Conclusion: L-DOPA was shown to downregulate DAT in some PD model rats. That process may be involved in the pathogenesis of dyskinesia. PMID: 21876323 [PubMed - as supplied by publisher] (Source: Neuro-Degenerative Diseases)

The modulation of Amyotrophic Lateral Sclerosis risk by Ataxin-2 intermediate polyglutamine expansions is a specific effect.

Neurobiology of Disease — Wed, 24 Aug 2011 23:00:00 +0100

Authors: Gispert S, Kurz A, Waibel S, Bauer P, Liepelt I, Geisen C, Gitler AD, Becker T, Weber M, Berg D, Andersen PM, Krüger R, Riess O, Ludolph AC, Auburger G Abstract Full expansions of the polyglutamine domain (polyQ≥34) within the polysome-associated protein ataxin-2 (ATXN2) are the cause of a multi-system neurodegenerative disorder, which usually presents as a Spino-Cerebellar Ataxia and is therefore known as SCA2, but may rarely manifest as Levodopa-responsive Parkinson syndrome or as motor neuron disease. Intermediate expansions (27≤polyQ≤33) were reported to modify the risk of Amyotrophic Lateral Sclerosis (ALS). We have now tested the reproducibility and the specificity of this observation. In 559 independent ALS patients from Central Europe, the association of ATX...

Extended-release pramipexole in early Parkinson disease: A 33-week randomized controlled trial

Neurology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusions: As monotherapy for early PD, pramipexole ER was noninferior to pramipexole IR and significantly more effective than placebo. Tolerability and safety did not differ between the formulations. Classification of evidence: This study provides Class I evidence that pramipexole ER is not inferior to pramipexole IR in patients with early PD. Neurology® 2011;77:759–766 (Source: Neurology)

Extended-release pramipexole in advanced Parkinson disease: A randomized controlled trial

Neurology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusions: Extended-release pramipexole significantly improved UPDRS score and off-time compared with placebo, with similar efficacy, tolerability, and safety of immediate-release pramipexole compared with placebo. Classification of evidence: This study provides Class I evidence that the extended-release form of pramipexole, taken once daily, is efficacious as an adjunct to levodopa in advanced PD. Neurology® 2011;77:767–774 (Source: Neurology)

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Second Trial of Extended-Release Carbidopa-Levodopa PositiveSecond Trial of Extended-Release Carbidopa-Levodopa Positive

Medscape Today Headlines — Mon, 15 Aug 2011 19:37:45 +0100

Top-line results from the ASCEND-PD trial show a greater reduction in "off time" with IPX066 compared with an existing treatment. Medscape Medical News (Source: Medscape Today Headlines)

GSK and Impax announce positive topline results of ASCEND-PD Phase III study of IPX066 in Advanced Parkinson’s disease

GSK news — Mon, 15 Aug 2011 11:23:37 +0100

GlaxoSmithKline (GSK) and Impax Pharmaceuticals, the branded products division of Impax Laboratories, Inc. (NASDAQ: IPXL) today announced top-line results of the ASCEND-PD Phase III clinical study of IPX066 versus carbidopa-levodopa plus entacapone (CLE), in patients with advanced Parkinson’s disease (PD). IPX066 is an extended release capsule formulation of carbidopa-levodopa (CD-LD) under investigation for the treatment of the motor symptoms of PD. (Source: GSK news)

Targeting Nicotinic Receptors for Parkinson's Disease Therapy.

CNS and Neurological Disorders Drug Targets — Sun, 14 Aug 2011 23:00:00 +0100

Authors: Quik M, Bordia T, Huang L, Perez X Abstract A promising target for improved therapeutics in Parkinson's disease is the nicotinic acetylcholine receptor (nAChR). nAChRs are widely distributed throughout the brain, including the nigrostriatal system, and exert important modulatory effects on numerous behaviors. Accumulating evidence suggests that drugs such as nicotine that act at these sites may be of benefit for Parkinson's disease treatment. Recent work indicates that a potential novel therapeutic application is the use of nicotine to reduce levodopa-induced dyskinesias, a side effect of dopamine replacement therapy for Parkinson's disease. Several clinical trials also report that nicotine may diminish disease symptoms. Not only may nAChR drugs provide symptomatic improve...

The Surgical Management of Parkinson's Disease.

CNS and Neurological Disorders Drug Targets — Sun, 14 Aug 2011 23:00:00 +0100

Authors: Ponce FA, Lozano AM Abstract There has been renewed interest in the surgical treatment of Parkinson's disease (PD) over the past 20 years. In the 1940's to 1960's many PD patients underwent neurosurgical procedures to ablate specific brain targets to alleviate tremor and, to a lesser extent, akinesia and rigidity. With the introduction of levodopa in the 1960s, and the realization of its striking benefits, surgical treatment of movement disorders virtually disappeared. With time, limitations and adverse effects associated with drug treatment became all too apparent. With complications associated with long-term drug treatment, particularly levodopa-induced motor fluctuations and dyskinesias, limiting therapeutic effectiveness in many patients, surgery has been reexamined to...

Abnormal bidirectional plasticity-like effects in Parkinson's disease

Brain — Fri, 12 Aug 2011 23:00:00 +0100

Levodopa-induced dyskinesia is a major complication of long-term dopamine replacement therapy for Parkinson’s disease that becomes increasingly problematic in advanced Parkinson’s disease. Although the cause of levodopa-induced dyskinesias is still unclear, recent work in animal models of the corticostriatal system has suggested that levodopa-induced dyskinesias might result from abnormal control of synaptic plasticity. In the present study, we aimed to explore control of plasticity in patients with Parkinson’s disease with and without levodopa-induced dyskinesias by taking advantage of a newly developed protocol that tests depotentiation of pre-existing long-term potentiation-like synaptic facilitation. Long-term potentiation-like plasticity and its reversibility were st...

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Site of deep brain stimulation and jaw velocity in Parkinson disease.

Journal of Neurosurgery — Thu, 11 Aug 2011 23:00:00 +0100

Conclusions The authors' results suggest that either the electrode implant in STN or the subsequent period of continuous STN stimulation negatively affected voluntary jaw velocity, including the loss of the preoperative levodopa-induced improvement. While the GPi group showed some improvement in voluntary jaw velocity postoperatively, their performance during the combination of DBS and levodopa was not different from their best medical management presurgery. The results have implications for DBS target selection, particularly for those patients with oromotor dysfunctions. PMID: 21838506 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease

Computational Intelligence and Neuroscience — Tue, 09 Aug 2011 14:20:59 +0100

This study sought to develop a patient-based instrument that would accurately capture the experience of patients with NMFs. Patient-based nominal group technique sessions, focus groups, and expert opinion were utilized in developing this questionnaire. (Source: Computational Intelligence and Neuroscience)

Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation [Original Contribution]

Archives of Neurology — Sun, 07 Aug 2011 23:00:00 +0100

Deep Brain Stimulation in Benign Tremulous Parkinsonism [Original Contribution]

Archives of Neurology — Sun, 07 Aug 2011 23:00:00 +0100

Conclusions These findings support the efficacy of DBS, with VIM and STN targets, in medically refractory BTP-related tremor. Further studies are needed to explore the long-term durability of response and to better compare the surgical targets. (Source: Archives of Neurology)

Resting Tremor in Parkinson Disease: A Negative Predictor of Levodopa-Induced Dyskinesia [Original Contribution]

Archives of Neurology — Sun, 07 Aug 2011 23:00:00 +0100

Conclusion Resting tremor as an initial manifestation of PD predicts lower probability of developing LID under levodopa treatment. (Source: Archives of Neurology)

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Efficacy, safety and tolerability of rasagiline as adjunctive therapy in elderly patients with Parkinson’s disease

European Journal of Neurology — Thu, 04 Aug 2011 23:00:00 +0100

Conclusions: Adjunct rasagiline is efficacious and well tolerated in elderly non‐demented patients (≥70 years) with moderate to advanced PD. Confirmation of the efficacy and safety of rasagiline in the elderly patient subgroup is especially relevant because of the increasing number of elderly patients with PD. (Source: European Journal of Neurology)

Targeting NR2A-containing NMDA receptors reduces L-DOPA-induced dyskinesias.

Neurobiology of Aging — Thu, 04 Aug 2011 23:00:00 +0100

Authors: Gardoni F, Sgobio C, Pendolino V, Calabresi P, Di Luca M, Picconi B Levodopa (L-DOPA)-induced dyskinesias represent the main side effect of the therapeutic strategy clinically used in Parkinson's disease (PD) treatment. The first beneficial "honeymoon" phase of L-DOPA therapy is followed by a phase of deterioration in which L-DOPA administration causes motor fluctuations in the drug efficacy ("on-off" state) and dyskinesias. Alterations of the composition and function of N-methyl-D-aspartate (NMDA) receptor represent one of the main causes for the striatal synaptic changes described in experimental model of dyskinesias. In the present study, the modulation of the composition of synaptic NMDA receptor by using a cell-permeable peptide targeting NR2A subunit during the developme...

Merck Completes Patient Enrollment in SETTLE, a Phase III Pivotal Clinical Trial of Safinamide in Advanced Parkinson?s Disease

Drugs.com - Pharma News — Fri, 29 Jul 2011 14:29:36 +0100

Study will evaluate efficacy and safety of safinamide as add-on therapy to a stable dose of levodopa Darmstadt, July 29, 2011 – Merck KGaA announced today, that its Merck Serono division and partner Newron Pharmaceuticals S.p.A. completed... (Source: Drugs.com - Pharma News)

Treatment of Apathy in Huntington’s Disease and Other Movement Disorders

Current Treatment Options in Neurology — Thu, 28 Jul 2011 15:54:04 +0100

Opinion statement Apathy is one of the most prevalent neurobehavioral symptoms in Huntington’s disease (HD), occurring in approximately 70% of the symptomatic HD population. Apathy scores in patients with HD are highly correlated with duration of illness, suggesting that apathy is an inevitable consequence of advanced disease. Although less distressing than symptoms like depression and less disruptive than irritability or aggression, apathy has a considerable adverse impact on those affected with HD because it leads to a decrease of the goal-directed behaviors that contribute much to the day-to-day quality of life. As a neuropsychiatric syndrome, apathy is also common in patients with other neuropsychiatric disorders such as Parkinson’s disease, traumatic brain injury,...

CARBIDOPA AND LEVODOPAtablet, Extended Release [UDL Laboratories, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 27 Jul 2011 05:00:00 +0100

Updated Date: Jul 27, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Preliminary Data From Exploratory Phase II Study Demonstrates Significant Activity of Droxidopa in Adult Attention Deficit Hyperactivity Disorder (ADHD)

Medical News (via PRIMEZONE) — Tue, 26 Jul 2011 12:00:00 +0100

CHARLOTTE, N.C., July 26, 2011 (GLOBE NEWSWIRE) -- Chelsea Therapeutics International, Ltd. (Nasdaq:CHTP) announced positive top-line results of an investigator-led Phase II clinical study of droxidopa in combination with carbidopa in adults with attention deficit hyperactivity disorder (ADHD). (Source: Medical News (via PRIMEZONE))

CARBIDOPA AND LEVODOPAtablet [Bryant Ranch Prepack]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 26 Jul 2011 05:00:00 +0100

Updated Date: Jul 26, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

CHMP approve Pramipexole Accord for Parkinson's treatment

Pharmacy Europe — Mon, 25 Jul 2011 12:14:00 +0100

Drug approved for use on its own or in combination with levodopa throughout course of disease (Source: Pharmacy Europe)

Correlation between the Movement Disorders Society Unified Parkinson’s Disease rating scale (MDS-UPDRS) and the Unified Parkinson’s Disease rating scale (UPDRS) during l-dopa acute challenge

Parkinsonism and Related Disorders — Mon, 25 Jul 2011 04:00:00 +0100

Abstract: While Movement Disorders Society Unified Parkinson’s Disease rating scale (MDS-UPDRS) validation has been exhaustive; performance evaluation to detect acute changes arising after administration of a single dose of l-dopa has yet to be explored. To determine the correlation between UPDRS and MDS-UPDRS during the acute challenge with ldopa and the MDS-UPDRS equivalent to 30% cutoff score of UPDRS for defining responsiveness, 64 patients were assessed. Consecutive assessments were performed immediately before and after administration of a single dose of l-dopa/carbidopa 250/25 mg using the motor section of the UPDRS and the MDS-UPDRS. Good diagnostic accuracy, consistent with published findings of high correlation between scales was observed. Area under the curve (AUC) was 0.99 (...

Levodopa/carbidopa: Dyskinesias in a child: case report

Reactions — Sun, 24 Jul 2011 19:59:43 +0100

(Source: Reactions)

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Malnutritional neuropathy under intestinal levodopa infusion

Journal of Neural Transmission — Sat, 23 Jul 2011 15:44:26 +0100

Abstract Levodopa/Carbidopa intestinal gel infusion (LCIG) for Parkinson’s disease is under debate to provoke polyneuropathy (PNP). In our cohort of 20 thus treated patients, two developed debilitating axonal PNP with deficient pyridoxin and folate levels, and marginal cobalamin. Homocysteine was highly elevated. The neuropathies responded to vitamin replacement. We assume that LCIG can provoke PNP most likely of malnutritional origin. To avoid this side effect, the assessment of predisposing factors before treatment as well as neurophysiological and laboratory screenings appear necessary. Content Type Journal ArticlePages 1-4DOI 10.1007/s00702-011-0689-3Authors Fabian Klostermann, Deptartment of Neurology, CBF, Charité-University Medicine Berlin, Hindenburdamm 30,...

Dopamine agonists and ischemic complications in Parkinson’s disease: a nested case–control study

European Journal of Clinical Pharmacology — Thu, 21 Jul 2011 18:16:57 +0100

Conclusions This study does not support an association between dopamine agonist use and an increased risk of ischemic events requiring hospitalization. Content Type Journal ArticlePages 1-6DOI 10.1007/s00228-011-1084-6Authors Maurits E. L. Arbouw, Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The NetherlandsKris L. L. Movig, Department of Clinical Pharmacy, Medisch Spectrum Twente, Enschede, The NetherlandsHenk-Jan Guchelaar, Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The NetherlandsCees Neef, Department of Clinical Pharmacy and Toxicology, University Hospital Maastricht, Maastricht, The NetherlandsToine C. G. Egberts, Department of Cl...

Carbidopa abrogates l‐dopa decarboxylase coactivation of the androgen receptor and delays prostate tumor progression

International Journal of Cancer — Wed, 20 Jul 2011 23:00:00 +0100

This study is a first time demonstration that carbidopa can abrogate DDC‐coactivation of AR in prostate cancer cells and tumors, decrease serum PSA, reduce tumor growth and delay CR progression. Since carbidopa is clinically approved, it may be readily used as a novel therapeutic strategy to suppress aberrant AR activity and delay prostate cancer progression. (Source: International Journal of Cancer)

Deep Brain Stimulation and Behavioural Changes: Is Comedication the Most Important Factor?

Neuro-Degenerative Diseases — Wed, 20 Jul 2011 23:00:00 +0100

Conclusion: For gambling performance, the medication dose mainly explains differences in impulsive behaviour. Although DBS had a minor negative effect on impulsive behaviour, the positive effect of a reduced DA dosis after DBS might reduce impulse control abnormalities. PMID: 21778695 [PubMed - as supplied by publisher] (Source: Neuro-Degenerative Diseases)

Constipation triggered the malignant syndrome in Parkinson’s disease

Neurological Sciences — Wed, 20 Jul 2011 12:28:11 +0100

Abstract A 69-year-old, chronically constipated patient with Parkinson’s disease developed fecal impaction and the malignant syndrome simultaneously, even while the patient was taking anti-parkinsonian drugs as prescribed. Administration of intravenous levodopa and oral Dai-kenchu-tou, an herbal medicine with serotonergic 5-HT3 receptor agonistic property successfully ameliorated his clinical symptoms. Constipation may trigger worsening of Parkinson’s disease and occurrence of the malignant syndrome by affecting levodopa absorption. Further, improved bowel motility may prevent worsening of Parkinson’s disease and occurrence of the malignant syndrome. Content Type Journal ArticlePages 1-4DOI 10.1007/s10072-011-0710-5Authors Emina Ogawa, Neurology, Internal Medic...

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CARBIDOPA AND LEVODOPAtablet [Cardinal Health]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 19 Jul 2011 05:00:00 +0100

Updated Date: Jul 19, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Does vigorous exercise have a neuroprotective effect in Parkinson disease?

Neurology — Sun, 17 Jul 2011 23:00:00 +0100

Parkinson disease (PD) is progressive, with dementia and medication-refractory motor problems common reasons for late-stage nursing-home placement. Increasing evidence suggests that ongoing vigorous exercise/physical fitness may favorably influence this progression. Parkinsonian animal models reveal exercise-related protection from dopaminergic neurotoxins, apparently mediated by brain neurotrophic factors and neuroplasticity (predicted from in vitro studies). Similarly, exercise consistently improves cognition in animals, also linked to enhanced neuroplasticity and increased neurotrophic factor expression. In these animal models, immobilization has the opposite effect. Brain-derived neurotrophic factor (BDNF) may mediate at least some of this exercise benefit. In humans, exercise increase...

Neural reward processing under dopamine agonists: Imaging

Journal of the Neurological Sciences — Fri, 15 Jul 2011 04:00:00 +0100

Abstract: Impulse control disorders (ICDs) are increasingly reported as a considerable side-effect of treatment with dopaminergic medication (both levodopa and dopamine agonists (DA)). ICDs together with punding are described within the entity of dopamine dysregulation syndrome along with immediate reward seeking and addictive behaviors. The brain functions involved in reward processing in general and their modulation by medication can be characterized by neuropsychological assessments and underlying neurobiology can be investigated by functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI) or positron emission tomography (PET). By this approach, functional changes of brain areas involved in reward processing under short-term or chronic DA therapy were studi...

Crossover comparison of IPX066 and a standard levodopa formulation in advanced Parkinson's disease

Movement Disorders — Tue, 12 Jul 2011 23:00:00 +0100

The objective of the study was to compare the pharmacokinetics, motor effects, and safety of IPX066, a novel extended‐release formulation of carbidopa‐levodopa, with an immediate‐release carbidopa‐levodopa formulation in advanced Parkinson's disease. We performed an open‐label crossover study in 27 subjects with advanced Parkinson's disease experiencing motor fluctuations on levodopa therapy. Subjects were randomized 1:1 to 8 days' treatment with either immediate‐release carbidopa‐levodopa followed by IPX066 or IPX066 followed by immediate‐release carbidopa‐levodopa. Pharmacokinetic and motor assessments were undertaken on day 1 for 8 hours (following a single dose) and on day 8 for 12 hours (during multiple‐dose administration). Following a single dose of IPX066 or imm...

UK cost-effectiveness analysis of levodopa/carbidopa intestinal gel (Duodopa®) in late stage Parkinson's disease

NeLM - News — Mon, 11 Jul 2011 23:00:00 +0100

Source: Journal of Medical Economics Area: News The authors of this cost-effectiveness analysis note that Parkinson's disease (PD) causes significant disability, which impacts substantially on patients' activities of daily life. Although symptoms are well controlled in the early stages of disease, disease progression leads to loss of treatment effect - an increased time spent in the 'off'' state. In advanced PD, patients' and carers' quality of life (QoL) is severely impacted and caregiver burden is considerable. Current treatments available for patients with advanced PD include oral therapies, infusion strategies (for example apomorphine or intraduodenal levodopa) and deep brain stimulation (DBS) techniques. Treatment options for those who have failed or are ...

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Amantadine attenuates levodopa‐induced dyskinesia in mice and rats preventing the accompanying rise in nigral GABA levels

Journal of Neurochemistry — Thu, 07 Jul 2011 23:00:00 +0100

AbstractAmantadine is the only drug marketed for treating levodopa‐induced dyskinesia. However, its impact on basal ganglia circuitry in the dyskinetic brain, particularly on the activity of striatofugal pathways, has not been evaluated. We therefore used dual probe microdialysis to investigate the effect of amantadine on behavioral and neurochemical changes in the globus pallidus and substantia nigra reticulata (SNr) of 6‐hydroxydopamine hemilesioned dyskinetic mice and rats. Levodopa evoked abnormal involuntary movements (AIMs) in dyskinetic mice, and simultaneously elevated GABA release in SNr (∼3‐fold) but not globus pallidus. Glutamate levels were unaffected in both areas. Amantadine (40 mg/Kg, i.p.), ineffective alone, attenuated (∼50%) AIM expression and prevented the GABA...

Tardive syndrome and Parkinson’s disease responsive to concomitant tetrabenazine and levodopa therapy

Parkinsonism and Related Disorders — Wed, 06 Jul 2011 04:00:00 +0100

We report a case with video recordings illustrating clinical features and positive response to concomitant dopamine depletor and levodopa therapy, providing insight into the pathogenesis of parkinsonism, tardive symptoms and possible therapeutic strategies. (Source: Parkinsonism and Related Disorders)

Dopaminergic drug-induced modulation of the expression of the dopamine transporter in peripheral blood lymphocytes in Parkinson's disease.

Pharmacological Reports — Fri, 01 Jul 2011 04:00:00 +0100

Authors: Fanciulli A, Misasi R, Campanelli D, Buttarelli FR, Pontieri FR Abstract The modulation of expression of the dopamine transporter by dopaminergic drugs was investigated by flow cytometry in peripheral blood lymphocytes from patients suffering Parkinson's disease. An 8-week in vivo exposure to pramipexole (0.7 mg free base, 3 times a day) or ropinirole (12 mg, once daily), but not levodopa/carbidopa (100/25 mg, 3 times a day), significantly reduced the mean fluorescence intensity of the dopamine transporter in peripheral blood lymphocytes. These results demonstrate that levodopa differs from dopamine agonists in its regulation of dopamine transporter expression in peripheral blood lymphocytes. PMID: 22001994 [PubMed - in process] (Source: Pharmacological Reports)

Buspirone improves the anti-cataleptic effect of levodopa in 6-hydroxydopamine-lesioned rats.

Pharmacological Reports — Fri, 01 Jul 2011 04:00:00 +0100

Authors: Mahmoudi J, Nayebi AM, Samini M, Reyhani-Rad S, Babapour V Abstract In Parkinson's disease (PD), prolonged exposure to L-3,4-dihydroxyphenylalanine (L-DOPA) results in motor fluctuations, such as the on-off phenomenon, and L-DOPA-induced dyskinesia. Previously, we found that activation of 5-HT(1A) in the substantia nigra pars compacta (SNc) decreased catalepsy in parkinsonian rats. In the current investigation, we attempted to evaluate the effect of buspirone on the anti-cataleptic effect of L-DOPA in 6-hydroxydopamine (6-OHDA)-lesioned male Wistar rats. Catalepsy was induced by the unilateral infusion of 6-OHDA (8 μg/2 μl/rat) into the central region of the SNc. After a 3-week recovery period, rats received L-DOPA intraperitoneally (ip; 15 mg/kg) twice daily for 20 days...

Jejunal levodopa infusion in long‐term DBS patients with Parkinson's disease

Movement Disorders — Mon, 27 Jun 2011 23:00:00 +0100

(Source: Movement Disorders)

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Levodopa ameliorated anorectal constipation in de novo Parkinson’s disease: The QL-GAT study

Parkinsonism and Related Disorders — Mon, 27 Jun 2011 04:00:00 +0100

Abstract: Background: Gastrointestinal tract (GIT) dysfunction is common in Parkinson’s disease (PD) patients. However, it remains unclear whether levodopa affects GIT function in PD.Objective: To perform an open study of levodopa’s effects on anorectal constipation in de novo PD patients by the quantitative lower-gastrointestinal autonomic test (QL-GAT).Methods: Nineteen unselected de novo PD patients (10 men, 9 women; mean age, 66 years; mean duration of the disease, 2.2 years) were recruited for the study. Eighteen of the patients reported constipation. These patients were treated with 200/20 mg b.i.d. of levodopa/carbidopa for 3 months. Pre- and post-treatment, objective parameters in the QL-GAT that comprised the colonic transit time (CTT) and rectoanal videomanometry were obtain...

CHMP recommends approval of Entacapone Orion (entacapone) and Levodopa/Carbidopa/Entacapone Orion (levodopa/carbidopa/entacapone)

NeLM - News — Sun, 26 Jun 2011 23:00:00 +0100

Source: European Medicines Agency Area: News The Committee for Medicinal Products for Human Use (CHMP) has adopted positive opinions, recommending the granting of marketing authorisations for the following two products, both intended for the treatment of adult patients with Parkinson's disease and end-of-dose motor fluctuations. 'Informed consent' applications were submitted for both medicines - this application type requires reference to be made to an authorised medicine (as stated below) and the marketing authorisation holder of this reference product to give consent to the use of its original dossier in the application procedure. . Entacapone Orion (entacapone) (reference product Comtess®) . Levodopa/Carbidopa/Entacapone Orion (levodopa/carbidopa/entacapo...

Impulse control disorders in Chinese Parkinson’s disease patients: The effect of ergot derived dopamine agonist

Parkinsonism and Related Disorders — Sun, 26 Jun 2011 23:00:00 +0100

Conclusions: 7% of our Chinese PD subjects had impulse control disorders. When young Parkinson’s disease patients with a history of anxiety or depression are treated with high dose of DA, they are at risk of developing impulse control disorders. (Source: Parkinsonism and Related Disorders)

Improvements in nocturnal symptoms with ropinirole prolonged release in patients with advanced Parkinson’s disease

European Journal of Neurology — Fri, 24 Jun 2011 16:19:17 +0100

Conclusions: Once‐daily ropinirole prolonged release improves nocturnal symptoms in patients with advanced PD not optimally controlled with levodopa who suffer troublesome nocturnal disturbance. (Source: European Journal of Neurology)