Hostname: page-component-745bb68f8f-g4j75 Total loading time: 0 Render date: 2025-01-22T18:22:36.910Z Has data issue: false hasContentIssue false
  • English
  • Français

Continuous Dopaminergic Stimulation in Parkinson's Disease

Published online by Cambridge University Press:  05 January 2016

J.A. Obeso ,
M.R. Luquin ,
J. Vaamonde ,
F. Grandas  and
J.M. Martinez Lage
J.A. Obeso*
Affiliation:
Movement Disorders Unit, Department of Neurology, University of Navarra, Medical School, Pamploma, Spain
M.R. Luquin
Affiliation:
Movement Disorders Unit, Department of Neurology, University of Navarra, Medical School, Pamploma, Spain
J. Vaamonde
Affiliation:
Movement Disorders Unit, Department of Neurology, University of Navarra, Medical School, Pamploma, Spain
F. Grandas
Affiliation:
Movement Disorders Unit, Department of Neurology, University of Navarra, Medical School, Pamploma, Spain
J.M. Martinez Lage
Affiliation:
Movement Disorders Unit, Department of Neurology, University of Navarra, Medical School, Pamploma, Spain
*
Clinica Universitaria, Apartado 19, 31080 Pamploma, Spain
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Complex motor fluctuations and dyskinesias (“on-off” phenomenon) in Parkinson's disease can be corrected by parenteral administration of levodopa, levodopa-methyl-ester, lisuride and apomorphine. Levodopa and levodopa-methyl-ester may only be administered intravenously because of their low solubility. Lisuride and apomorphine are readily absorbed after subcutaneous administration. Repeated or continuous intravenous infusions of levodopa have been given for a few days, using a wearable “jacket-like” pump, with good results. So far, lisuride is the only dopamine agonist used for chronic treatment by continuous infusion. The “on-off” effect is adequately controlled in most patients by subcutaneous lisuride administration (plus oral levodopa). However, adverse effects, particularly psychiatric complications, constitute a major limiting factor for routine applications of this form of treatment. Subcutaneous apomorphine infusion is unlikely to become a standard therapeutic procedure in Parkinson's disease, but it is a very valuable research method to gain further insight into the pathophysiology of motor fluctuations in Parkinson's disease.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 14 , Issue S3 , August 1987 , pp. 488 - 492
Copyright
Copyright © Canadian Neurological Sciences Federation 1987

References

REFERENCES

1.Marsden, CD, Parkes, JD. “On-off” effects in patients with Parkinson’s disease in chronic levodopa therapy. Lancet 1976; 1: 292–296.CrossRefGoogle ScholarPubMed
2.Lewitt, PA, Chase, TN. “On-off” effects; the new challenge in parkinsonism. Trends Neurosci 1983; 6: 1–4.CrossRefGoogle Scholar
3.Fahn, S. Fluctuations of disability in Parkinson’s disease: Patho-physiology. In: Movement Disorders, ed. Marsden, CD and Fahn, S. Butterworth, London 1982; 123–145.Google Scholar
4.Marsden, CD, Parkes, JD, Quinn, N. Fluctuations of disability in Parkinson’s disease: Pathophysiological aspects. In: Movement Disorders. Marsden, CD and Fahn, S, eds. Butterworth, London 1982; 96–122.Google Scholar
5.Fahn, S. Episodic failure of absorption of L-dopa: A factor in the control of clinical fluctuations in the treatment of parkinsonism. Neurology 1977; 27 (suppl 2): 390.Google Scholar
6.Melamed, E. Initiation of levodopa therapy in parkinsonian patients should be delayed until the advanced stages of the disease. Arch of Neurology 1986; 43: 402–405.CrossRefGoogle ScholarPubMed
7.Schwab, RS, Amador, LV, Lettvin, JY. Apomorphine in Parkinson’s disease. Trans Amer Neurol Assoc 1951; 76: 2512–2513.Google Scholar
8.Nutt, JG, Fellman, JH. Pharmacokinetics of levodopa. Clin Neuro-pharm 1984; 7: 35–50.Google ScholarPubMed
9.Gervas, JJ, Muradas, V, Bazan, E, et al. Effects of 3-OM-dopa on monamine metabolism in rat brain. Neurology (Cleveland) 1983; 33: 278–282.CrossRefGoogle Scholar
10.Reches, A, Nuelke, LR, Fahn, S. 3-0-Methyldopa inhibits rotations induced by levodopa in rats after unilateral destruction of the nigrostriatal pathway. Neurology (NY) 1983; 32: 887–888.CrossRefGoogle Scholar
11.Sthal, S. Applications of new drug delivery technologies to Parkinson’s disease and dopaminergic agents. J Neural Trans (in press).Google Scholar
12.Obeso, JA, Sthal, S. New routes of administration for antiparkinsonian therapy. “Drugs for the treatment of Parkinson’s disease”. Calne, DB, Springer-Verlag, Berlin (in press).Google Scholar
13.Shoulson, I, Glaubiger, GA, Chase, TN. On-off response: Clinical and biochemical correlations during oral and intravenous levodopa administration in parkinsonian patients. Neurology 1975: 25: 1144–1148.CrossRefGoogle ScholarPubMed
14.Rosin, AJ, Devereux, D, Calne, DB. Parkinsonism with “on-off” phenomena-intravenous treatment with levodopa after major abdominal surgery. Arch Neurol 1979; 36: 32–34.CrossRefGoogle ScholarPubMed
15.Quinn, NP, Parkes, JD, Marsden, CD. Control of “on-off” phenomenon by continuous intravenous infusion of levodopa. Neurology 1984; 34: 1131–1136.CrossRefGoogle ScholarPubMed
16.Hardie, RJ, Lees, AJ, Stern, GM. On-off fluctuations in Parkinson’s disease: A clinical and neuropharmacological study. Brain 1984; 107: 487–506.CrossRefGoogle ScholarPubMed
17.Nutt, JG, Woodward, WR, Hammerstad, JP, et al. The “on-off” phenomenon in Parkinson’s disease. New Eng J Med 1984; 310: 483–488.CrossRefGoogle Scholar
18.Marion, MH, Stocchi, F, Quinn, NP, et al. Repeated levodopa infusions in fluctuating Parkinson’s disease: Clinical and pharmacokinetic data. Clin Neuropharm 1986; 9: 165–181.CrossRefGoogle ScholarPubMed
19.Chase, TN, Mouradian, MM, Fabbrini, G, et al. Pathogenetic studies of motor fluctuations in Parkinson’s disease. J Neurol Trans (in press).Google Scholar
20.Luquin, MR, Obeso, JA, Martinez Lage, JM, et al. Levodopa and 3-0-Methyldopa plasma levels in Parkinson’s disease: Patients with clinical fluctuations versus smooth responders. Neurology 1986; 36 (supp 1): 244.Google Scholar
21.Cooper, DR, Marrel, C, Testa, B, et al. L-Dopa Methyl Ester: A candidate for chronic systemic deli very of L-Dopa in Parkinson’s disease. Clin Neuropharm 1984; 7: 88–98.CrossRefGoogle Scholar
22.Obeso, JA, Martinez Lage, JM, Luqwuin, MR. Lisuride infusion for Parkinson’s disease. Ann Neurol 1983; 14: 134.CrossRefGoogle ScholarPubMed
23.Obeso, JA, Luquin, MR, Martinez Lage, JM. Intravenous lisuride corrects motor oscillations in Parkinson’s disease. Ann Neurol 1986a; 19: 31–35.CrossRefGoogle ScholarPubMed
24.Luquin, MR, Obeso, JA, Martinez Lage, JM, et al. Parenteral administration of lisuride in Parkinson’s disease. Adv Neurol 1987: 45.Google ScholarPubMed
25.Obeso, JA, Luquin, MR, Martinez Lage, JM. Lisuride infusion pump: A device for the treatment of motor fluctuations in Parkinson’s disease. Lancet 1986b; 1: 467–470.CrossRefGoogle ScholarPubMed
26.Obeso, JA, Luquin, MR, Vaamonde, J, et al. Continuous subcutaneous administration of lisuride in the treatment of complex motor fluctuations in Parkinson’s disease. J Neural Trans (in press).Google Scholar
27.Critchley, P, Grandas, F, Quinn, N, et al. Continuous subcutaneous lisuride infusions in Parkinson’s disease. J Neural Trans (in press).Google Scholar
28.Ruggieri, S, Stocchi, F, Agnoli, A. Lisuride infusion pump for Parkinson’s disease. Lancet 1986; 11: 348–349.CrossRefGoogle Scholar
29.Vaamonde, J, Obeso, JA, Luquin, R. Increased levodopa consumption reduces motor response to apomorphine in Parkinson’s disease. Neurology 1987; (suppl 1): 37.Google Scholar
30.Cotzias, GC, Mena, I, Papavasilious, PS. Overview of present treatment of parkinsonism with levodopa. Adv Neurol 1973; 2: 265–277.Google Scholar
31.Winkler, JD, Weiss, B. Reversal of supersensitivity apomorphine induced rotational behaviour in mice by continuous exposure to apomorphine. J Phar Exp Therap 1986; 238: 242–247.Google ScholarPubMed
32.Stoessl, AJ, Mak, E, Calne, DB. (+)-4-propyl-9-hydroxynaphthoxazine (PHNO), a new dopaminomimetic, in treatment of parkinsonism. Lancet 1985; 2: 1330–1331.CrossRefGoogle ScholarPubMed
33.Grandas Perez, F, Jenner, J, Nomoto, M, et al. (+)-4-propyl-9-hydroxynaphthoxazine in Parkinson’s disease. Lancet 1986; 1: 906.CrossRefGoogle ScholarPubMed
34.Coleman, RJ, Grandas Perez, F, Quinn, N, et al. 4-propyl-9-hydroxy-naphthoxazine in Parkinson’s disease and MPTP models (in press).Google Scholar