Levodopa challenge test: indications, protocol, and guide

Abstract

A drug challenge test in Parkinson’s disease, such as the levodopa challenge test (LCT), is an easy and generally safe procedure, which has been used by clinicians for various indications. The results of the test have significant implications in the management of patients, from preoperative evaluation for deep brain stimulation to providing the basis for medication adjustments to address motor or non-motor fluctuations and dyskinesias. This paper reviews the different indications and protocols commonly used in an acute LCT. Potential complications of the procedure and an overview of levodopa responsiveness and unresponsiveness are also discussed.

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Funding

This study was supported in part by the Parkinson’s Foundation through its support of the fellowship training of G.S.

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GS performed a detailed review of the literature and undertook the writing of the manuscript. AEL provided critical comments, recommendations, and editorial contributions.

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Correspondence to Anthony E. Lang.

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Saranza, G., Lang, A.E. Levodopa challenge test: indications, protocol, and guide. J Neurol (2020). https://doi.org/10.1007/s00415-020-09810-7

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Keywords

  • Levodopa challenge test
  • Parkinson's disease
  • DBS screening
  • Levodopa responsiveness
  • Levodopa unresponsiveness
  • Short-duration response