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The effect of levodopa treatment on vascular endothelial function in Parkinson’s disease

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Abstract

Objective

There has been increasing awareness that micro-vascular alteration or vascular inflammation has been associated with levodopa-induced dyskinesia in PD. Vascular endothelial function assessed by flow mediated dilation (FMD) is known to reflect early microvascular change. We compare the impact of levodopa or dopamine agonist treatment on the change of FMD in de novo PD patients.

Methods

This retrospective study used a selected sample from registry. We identified de-novo PD patients who underwent FMD at baseline, and follow-up FMD after 1 year (± 2 month) of levodopa (n = 18) or dopamine agonist (n = 18) treatment.

Results

FMD decreased after levodopa (8.60 ± 0.46 to 7.21 ± 0.4, p = 0.002) but there were no significant changes after DA treatment (8.33 ± 0.38 to 8.22 ± 0.33, p = 0.26). Homocysteine rose (11.52 ± 0.45 to 14.33 ± 0.68, p < 0.05) during levodopa treatment, but dopamine agonist had no effect (10.59 ± 0.38 to 11.38 ± 0.67, p = 0.184). Correlation analysis revealed that the changes in homocysteine level had non-significant correlation with FMD change (r =  − 0.30, p = 0.06). FMD change was not associated with age (p = 0.47), disease duration (p = 0.81), baseline motor UPDRS (p = 0.43), motor UPDRS change (p = 0.64), levodopa equivalent dose change (p = 0.65).

Conclusions

We found that 1-year levodopa treatment may adversely affect vascular endothelial function in de novo PD. Further studies are needed to clarify the exact pathogenesis and clinical implication of levodopa-induced endothelial dysfunction in PD.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (no. NRF-2022R1F1A1074588 (J.H.Y))

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Authors and Affiliations

  1. Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, World Cup ro, Suwon-si, Kyunggi-do, 442-749, South Korea

    Min Seung Kim, Don Gueu Park, Young Eun Gil, In Ja Shin & Jung Han Yoon

  2. Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea

    Min Seung Kim

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  1. Min Seung Kim
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Correspondence to Jung Han Yoon.

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Kim, M.S., Park, D.G., Gil, Y.E. et al. The effect of levodopa treatment on vascular endothelial function in Parkinson’s disease. J Neurol 270, 2964–2968 (2023). https://doi.org/10.1007/s00415-023-11622-4

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  • DOI: https://doi.org/10.1007/s00415-023-11622-4

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