Choice reaction time after levodopa challenge in parkinsonian patients

• Published in: Journal of the neurological sciences Vol. 181; no. 1; pp. 98 - 103
• Main Authors: Müller, Thomas, Benz, Sabiene, Przuntek, Horst
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier B.V 01.12.2000; Elsevier Science
• Subjects: Adult; Aged; Anticonvulsants. Antiepileptics. Antiparkinson agents; Biological and medical sciences; Choice reaction time; Domperidone - administration & dosage; Domperidone - adverse effects; Drug Interactions - physiology; Female; Humans; Levodopa; Levodopa - administration & dosage; Levodopa - adverse effects; Male; Medical sciences; Middle Aged; Movement - drug effects; Movement - physiology; Neuropharmacology; Parkinson Disease - drug therapy; Parkinson Disease - physiopathology; Parkinson Disease - psychology; Parkinson’s disease; Pharmacology. Drug treatments; Psychomotor Performance - drug effects; Psychomotor Performance - physiology; Reaction Time - drug effects; Reaction Time - physiology; Treatment Outcome; Choice reaction time; Parkinson’s disease; Levodopa; Human; Performance evaluation; Pharmacologic test; Nervous system diseases; Parkinson disease; Antiparkinson agent; Long term; De novo; Cerebral disorder; Chemotherapy; Treatment; Central nervous system disease; Adult; Degenerative disease; Technique; Extrapyramidal syndrome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/S0022-510X(00)00436-6

Various types of choice reaction time paradigms demonstrated deficits in the preparation and execution of movements in parkinsonian subjects. These studies showed controversial results, since they included parkinsonian individuals being: (i) previously untreated; (ii) off; or (iii) on anti-parkinsonian medication. Moreover, these trials do not take into consideration the acute effects of levodopa administration. Objective of this study was to determine the effect of long-term dopaminergic substitution therapy within a standardized levodopa challenge test in combination with a repeatedly performed choice reaction time task in parkinsonian individuals. Parkinsonian participants consisted of previously untreated, so-called “de-novo” patients and of individuals, who were chronically substituted with dopaminergic drugs, but were taken off medication for at least 12 h. All participants took 250 mg levodopa/benserazide after assessment of baseline data. Then we repeatedly measured choice reaction- and movement time within the next 90 min. No significant change of the assessed task data appeared in the “de-novo” group, but reaction- and movement time significantly shortened in previously treated subjects. Sedative effects of levodopa and/or dopaminergic overstimulation hypothetically explain the results of the previously untreated patients, whereas long-term dopaminergic substitution therapy hypothetically causes tolerance to these phenomena in treated parkinsonian individuals. Future studies on parkinsonian subjects should discuss their results on the basic pathophysiology or basal ganglia dysfunction in the light of a putative impact of long-term anti-parkinsonian drug therapy.