Advertisement

Parkinson’s Disease

Current Concepts
  • Abraham N. Lieberman
  • Menek Goldstein

Abstract

After more than a decade levodopa (combined with a peripheral decarboxylase inhibitor) remains the standard treatment for Parkinson’s disease (PD) with up to 90% of patients responding. However, levodopa does not halt the advance of the underlying disease, but by improving mobility, it delays the onset of fatal complications (Marsden and Parkes, 1977; Yahr et al., 1972). Thus, after 2–5 years many PD patients have increased disability. The increased disability may manifest itself by the reappearance of old symptoms, i.e., symptoms present before levodopa treatment, or by new symptoms, symptoms not present before levodopa treatment. Most of the new symptoms are disease manifestations seen only because patients live longer (postural instability, dementia), and some of the symptoms may result from the chronic effects of levodopa itself (dyskinesias, diurnal oscillations in performance).

Keywords

Parkinson Disease Ergot Alkaloid Levodopa Treatment Parkinsonian Symptom Decarboxylase Inhibitor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bernheimer, H., Birkmayer, W., Hornykiewicz, O., Jellinger, K., and Seitelberger, F., 1973, Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations, J. Neurol. Sci. 20: 415–455.Google Scholar
  2. Birkmayer, W., Riederer, P., Ambrozi, L., and Youdim, M. B. H., 1977, Implications of combined treatment with “Madopar” and L-deprenil in Parkinson’s disease: A long-term study, Lancet 1: 439–443.CrossRefGoogle Scholar
  3. Boller, F., Mizutani, T., Roessmann, U., and Gambetti, P., 1980, Parkinson disease, dementia, and Alzheimer disease. Clinicopathological correlations, Ann. Neurol. 7: 329–335.PubMedCrossRefGoogle Scholar
  4. Calne, D. B., Williams, A. C., Neophytides, A., Plotkin, C., Nutt, J. C., and Teychene, P. F., 1978, Long-term treatment of parkinsonism with bromocriptine, Lancet1: 735–738.PubMedCrossRefGoogle Scholar
  5. Diamond, S. G., Markham, C. H., and Treciokas, L. J., 1978, A double-blind comparison of levodopa, Madopar, and Sinemet in Parkinson disease, Ann. Neurol. 3: 267–272.PubMedCrossRefGoogle Scholar
  6. Direnfeld, L. K., Feldman, R. G., Alexander, M. P., and Kelly-Hayes, M., 1980, Is L-DOPA drug holiday useful? Neurology30: 785–788.PubMedGoogle Scholar
  7. Goldstein, M., Battista, A. F., Ohmoto, T., Anagnoste, B., and Fuxe, K., 1973, Tremor and involuntary movements in monkeys: Effect of L-DOPA and of a dopamine receptor stimulating agent, Science179: 816–887.PubMedCrossRefGoogle Scholar
  8. Goldstein, M., Lieberman, A., Lew, J. Y., Asano, T., Rosenfeld, M. R., and Markman, M. H., 1980, Interaction of pergolide with central dopaminergic receptors, Proc. Natl. Acad. Sci. USA77: 3725–3728.PubMedCrossRefGoogle Scholar
  9. Hakim, A. M., and Mathieson, G., 1979, Dementia in Parkinson disease: A neuropathologie study, Neurology29: 1209–1214.PubMedGoogle Scholar
  10. Hartog Jager, W. A. den, and Bethlem, J., 1960, The distribution of lewy bodies in the central and autonomic nervous system in idiopathic paralysis agitans, J. Neurol., Neurosurg. Psychiatry23: 283–289.CrossRefGoogle Scholar
  11. Hefti, F., Melamed, E., and Wurtman, R J, 1980, Partial lesions of the dopaminergic nigrostriatal system in rat brain: Biochemical characterization, Brain Res. 195: 123–137.Google Scholar
  12. Hoehn, M. M., and Yahr, M. D., 1967, Parkinsonism: Onset, progression, and mortality, Neurology17: 427–442.PubMedGoogle Scholar
  13. Hornykiewicz, O., 1974, The mechanisms of action of L-dopa in Parkinson’s disease, Life Sci. 15: 1249–1259.PubMedCrossRefGoogle Scholar
  14. Horowski, R., 1978, Differences in the dopaminergic effects of the ergot derivatives bromocriptine, lisuride and d-LSD as compared with apomorphine, Eur. J. Pharmacol. 51: 157–166.PubMedCrossRefGoogle Scholar
  15. Kebabian, J. W., Petzold, G. L., and Greegard, P., 1972, Dopamine-sensitive adenylate cyclase in caudate nucleus of rat brain, and its similarity to the “dopamine receptor,” Proc. Natl. Acad. Sci. USA69: 2145–2149.PubMedCrossRefGoogle Scholar
  16. Knoll, J., 1978, The possible mechanisms of action of (-) deprenyl in Parkinson’s disease, J. Neural. Transmis. 43: 177–198.CrossRefGoogle Scholar
  17. Langston, J. W., Ballard, P., and Tetrud, J. W., 1983, Chronic parkinsonism in humans due to a product of meperidine analog synthesis, Science219: 979–980.PubMedCrossRefGoogle Scholar
  18. Lees, A. J., Haddad, S., Shaw, K. M., Kohout, L. J., and Stern, G. M., 1978, Bromocriptine in parkinsonism: A long-term study, Arch. Neurol. 35: 503–505.PubMedCrossRefGoogle Scholar
  19. Lemberger, L., and Crabtree, R. E., 1979, Pharmacologic effects in man of a potent, long-acting dopamine receptor agonist, Science205: 1151–1153.PubMedCrossRefGoogle Scholar
  20. Lesser, R. P., Fahn, S., Snider, S., Cote, L. J., Isgreen, W. P., and Barrett, R. E., 1979, Analysis of the clinical problems in parkinsonism and the complications of long-term levodopa therapy, Neurology29: 1253–1260.PubMedGoogle Scholar
  21. Lewitt, P. A., Ward, C. D., Larsen, T. A., Raphaelson, M. I., Newman, R. P., Foster, N., Dambrosia, J. M., and Caine, D. M., 1983, Comparison of pergolide and bromocriptine therapy in parkinsonism, Neurology33: 1009–1014.PubMedGoogle Scholar
  22. Lieberman, A. N., 1974, Parkinson’s disease: A clinical review, Am. J. Med. Sci. 267: 66–80.PubMedCrossRefGoogle Scholar
  23. Lieberman, A. N., Goodgold, A. L., and Goldstein, M., 1973, Treatment failures with levodopa in parkinsonism, Neurology22: 1205–1210.Google Scholar
  24. Lieberman, A., Goodgold, A., Jonas, S., and Liebowitz, M., 1975, Comparison of dopa decarboxylase inhibitor (carbidopa) combined with levodopa and levodopa alone in Parkinson’s disease, Neurology25: 911–916.PubMedGoogle Scholar
  25. Lieberman, A., Estey, E., Gopinathan, G., Ohashi, T., Sauter, A., and Goldstein, M., 1978, Comparative effectiveness of two extracerebral DOPA decarboxylase inhibitors in Parkinson disease, Neurology28: 964–968.PubMedGoogle Scholar
  26. Lieberman, A., Dziatelowski, M., Kupersmith, M., Serby, M., Goodgold, A., Korein, J., and Goldstein, M., 1979a, Dementia in Parkinson disease, Ann. Neurol. 6: 355–359.PubMedCrossRefGoogle Scholar
  27. Lieberman, A.N., Gopinathan, G., Estey, E., Kupersmith, M., Goodgold, A., and Goldstein, M., 1979b, Lergotrile in Parkinson disease: Further studies, Neurology29: 267–272.Google Scholar
  28. Lieberman, A. N., Dziatelowski, M., Gopinathan, G., Kupersmith, M., Neophytides, A., and Konein, J., 1980a, The evaluation of Parkinson’s disease, in: Advances in Biochemical Psychopharmacology, Vol. 23 ( D. Caine, M. Goldstein, A. Lieberman, and M. Thorner, eds.), pp. 227–286, Raven Press, New York.Google Scholar
  29. Lieberman, A. N., Kupersmith, M., and Neophytides, A., 1980b, Bromocriptine in Parkinson’s disease: Report on 106 patients treated for up to 5 years, in: Ergot Compounds and Brain Function: Neuroendocrine and Neuropsychiatric Aspects( D. Caine, M. Goldstein, A. Lieberman, and M. Thorner, eds.), pp. 245–253, Raven Press, New York.Google Scholar
  30. Lieberman, A., Goldstein, M., Leibowitz, M., Neophytides, A., Kupersmith, M., Pact, V., and Kleinberg, D., 11981, Treatment of advanced Parkinson disease with pergolide, Neurology31: 675–682.Google Scholar
  31. Lieberman, A. N., Goldstein, M., Gopinathan, G., Leibowitz, M., Neophytides, A., Walker, R., Hiesigen, E., and Nelson, J., 1982, Further studies with pergolide in Parkinson disease, Neurology32: 1181–1184.PubMedGoogle Scholar
  32. Lieberman, A. N., Gopinathan, G., Neophytides, A., Leibowtiz, M., Walker, R., and Hiesigen, E., 1983a, Bromocriptine and lisuride in Parkinson disease, Ann. Neurol. 13: 44–47.PubMedCrossRefGoogle Scholar
  33. Lieberman, A. N., Goldstein, M., Gopinathan, G., Leibowitz, M., Neophytides, A., Walker, R., and Hiesigen, E., 1983b, Further studies with lisuride in Parkinson’s disease, Eur. Neurol. 23: 119–123.CrossRefGoogle Scholar
  34. Lieberman, A. N., Neophytides, A. N., Leibowitz, M., Gopinathan, G., Pact, V., Walker, R., Goodgold, A., and Goldstein, M., The comparative efficacy of pergolide and bromocriptine in patients with Parkinson disease, 1983c, in: Experimental Therapeutics of Movement Disorders, Vol. 37 (S. Fahn, D. B. Caine, and I. Shoulson, eds.), pp. 95–108, Raven Press, New York.Google Scholar
  35. Lieberman, A. N., Gopinathan, G., and Neophytides, A., 1984a, The antiparkinsonian efficacy of deprenyl: A specific type “B” monoamine oxidase inhibitor, NY State J. Med. 84: 13–16.Google Scholar
  36. Lieberman, A. N., Leibowitz, M., Neophytides, A. N., Gopinathan, G., Walker, R., Hiesigen, E., Collins, M., and Goldstein, M., 1984b, Pergolide and lisuride in advanced Parkinson’s disease, Adv. Neurol. 40: 503–507.PubMedGoogle Scholar
  37. Markham, C. H., and Diamond, S. G., 1981, Evidence to support early levodopa therapy in Parkinson disease, Neurology31: 125–131.PubMedGoogle Scholar
  38. Marsden, C. D., and Parkes, J. D., 1976, “On—off ’ effects in patients with Parkinson’s disease on chronic levodopa therapy, Lancet1:292–296.PubMedCrossRefGoogle Scholar
  39. Marsden, C. D., and Parkes, J. D., 1977, Success and problems of long-term levodopa therapy in Parkinson’s disease, Lancet1: 345–349.PubMedCrossRefGoogle Scholar
  40. Mayeux, R., Stern, Y., Rosen, J., and Leventhal, J., 1981, Depression, intellectual impairment, and Parkinson disease, Neurology31: 645–650.PubMedGoogle Scholar
  41. Melamed, E., Hefti, F., and Wurtman, R. J., 1980, Nonaminergic striatal neurons convert exogenous L-dopa to dopamine in parkinsonism, Ann. Neurol. 8: 558–563.PubMedCrossRefGoogle Scholar
  42. Narabayashi, H., Kondo, T., and Hayashi, A., 1981, L-Threo 3,4-dihydroxy-phenylserine treatment for akinesia and freezing of parkinsonism, Proc. Japan Acad. 57 (ser B): 351–354.CrossRefGoogle Scholar
  43. Reches, A., and Fahn, S., 1982, 3-O-methyldopa blocks dopa metabolism in rat corpus striatum, Ann. Neurol. 12: 267–271.PubMedCrossRefGoogle Scholar
  44. Rinne, U. K., and Mölsä, P., 1979, Levodopa with benserazide or carbidopa in, Parkinson disease, Neurology29: 1584–1589.Google Scholar
  45. Schwartz, R., Creece, J., and Coyle, J. T., 1978, Dopamine receptors localized on cerebral cortical afferents to rat corpus straitum, Nature271: 766–768.CrossRefGoogle Scholar
  46. Ungerstedt, U., 1971, Postsynaptic supersensitivity after 6-hydroxydopamine induced degeneration of the nigro-striatal dopamine system, Acta Physiol. Scandinavia., 367 (Suppl.): 69–93.Google Scholar
  47. Weiner, W. J., Koller, W. C., Perlik, S., Nausieda, P. A., and Klawans, H. L., 1980, Drug holiday and management of Parkinson disease, Neurology30: 1257–1261.PubMedGoogle Scholar
  48. Yahr, M. D., Wolf, A., and Antuner, J., 1972, Autopsy findings in parkinsonism following treatment with levodopa, Neurology22 (Suppl.): 56–71.Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Abraham N. Lieberman
    • 1
  • Menek Goldstein
    • 2
  1. 1.Department of NeurologyNew York University School of MedicineNew YorkUSA
  2. 2.Department of NeurochemistryNew York University School of MedicineNew YorkUSA

Personalised recommendations