Is Levodopa Response a Valid Indicator of Parkinson’s Disease?

Details

• Personal Author:
  Cairns NJ ; Criswell S ; Davis AA ; Hartlein J ; Kotzbauer PT ; Maiti B ; Martin WRW ; Miles M ; Norris SA ; Perlmutter JS ; Perrin RJ ; Racette BA ; Ushe M ; Zhong Q
• Description:
  Background: The clinical diagnosis of Parkinson's disease (PD) requires the presence of parkinsonism and supportive criteria that include a clear and dramatic beneficial response to dopaminergic therapy. Our aim 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) of those with autopsy-confirmed progressive supranuclear palsy, and 1 (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. [Description provided by NIOSH]
• Subjects:
  Diagnosis Drug Therapy Occupational Health Safety
• Keywords:
  Author Keywords: Parkinson's Disease Clinical Diagnosis Diagnostic Specificity Diagnostic Techniques Drug Therapy Levodopa Medical Treatment Neurological Diseases Parkinsonism Parkinsons Disease
• ISSN:
  1531-8257
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Missouri ; OSHA Region 7 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  36
• Issue:
  4
• NIOSHTIC Number:
  nn:20061717
• Citation:
  Mov Disord 2021 Apr; 36(4):948-954
• Contact Point Address:
  Dr. W.R. Wayne Martin, Department of Medicine (Neurology), University of Alberta, 963 Rice Road, Edmonton, AB, Canada T6R1B1
• Email:
  wmartin@ualberta.ca
• CAS Registry Number:
  DOPA (CAS RN 59-92-7)
• Federal Fiscal Year:
  2021
• NORA Priority Area:
  Construction ; Manufacturing
• Performing Organization:
  University of California, San Diego
• Peer Reviewed:
  True
• Start Date:
  20190801
• Source Full Name:
  Movement Disorders
• End Date:
  20230731
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:da2834a60ef17a3a73634860b027e904b6b449667c4c930d9f5f6bda2fd182f4c054715ec30be3dcab8d45e575ca1f6458f798113143f6b499f8229fc987b3e5
• Download URL:
  https://stacks.cdc.gov/view/cdc/225144/cdc_225144_DS1.pdf
• File Type:
  [PDF - 160.57 KB ]