i
Is levodopa response a valid indicator of Parkinson disease?
-
11 30 2020
Source: Mov Disord. -
Alternative Title:Mov Disord
-
Personal Author:
-
Description:Objective/background
The clinical diagnosis of Parkinson disease (PD) requires the presence of parkinsonism and supportive criteria that include a clear and dramatic beneficial response to dopaminergic therapy. Our objective was to test the diagnostic criterion of dopaminergic response by evaluating its association with pathologically confirmed diagnoses in a large population of parkinsonian patients.
Methods
We reviewed clinical data maintained in an electronic medical record from all patients with autopsy data who had been seen in the Movement Disorders Center at Washington University, St. Louis between 1996 and 2018. All patients with parkinsonism who underwent postmortem neuropathologic examination were included in this analysis.
Results
There were 257 unique parkinsonian patients with autopsy-based diagnoses who had received dopaminergic therapy. Marked or moderate response to dopaminergic therapy occurred in 91.2% (166/182) of those with autopsy-confirmed PD, 52.0% (13/25) of those with autopsy-confirmed multiple systems atrophy, 44.4% (8/18) with autopsy-confirmed progressive supranuclear palsy, and one (1/8) with autopsy-confirmed corticobasal degeneration. Other diagnoses were responsible for the remaining 24 individuals, 9 of whom had a moderate response to dopaminergic therapy.
Conclusion
A substantial response to dopaminergic therapy is frequent but not universal in PD. An absent response does not exclude PD. In other neurodegenerative disorders associated with parkinsonism, a prominent response may also be evident but this occurs less frequently than in PD.
-
Subjects:
-
Source:
-
Pubmed ID:33253432
-
Pubmed Central ID:PMC8046721
-
Document Type:
-
Funding:
-
Collection(s):
-
Main Document Checksum:
-
File Type: