Influence of white matter MRI hyper-intensities on acute l-dopa response in patients with Parkinson's disease

Parkinsonism & Related Disorders
J E ArenaMarcelo Merello

Abstract

To determine whether brain white matter hyperintensities (WMH) influence l-dopa response in Parkinson's disease (PD) patients. We prospectively evaluated 60 PD patients with an acute l-dopa challenge test, and assessed motor performance with the Movement Disorders Society revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) during "ON" and "OFF" medication states. Magnetic resonance images were examined using a visual semi-quantitative rating scale for quantification and distribution analysis of WMH. l-dopa challenge test response was correlated to extent and location of WMH, to determine a potential association between them. Subjects with greater deep WMH burden, showed less response to l-dopa on axial motor symptoms (R = -0.35; p < 0.027), when tested with Part III of the MDS-UPDRS before and after acute levodopa challenge. Results suggest WMH may affect response to l-dopa on axial function of PD patients, which could be due to either non-dopaminergic (cortico-basal ganglia) motor pathway disruption, or postsynaptic nigrostriatal pathway involvement.

References

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Citations

Feb 8, 2020·Annals of Clinical and Translational Neurology·Seok Jong ChungPhil Hyu Lee
Aug 29, 2020·Journal of Movement Disorders·Seok Jong ChungYoung H Sohn
Apr 24, 2020·Translational Neurodegeneration·Chao GaoShengdi Chen
Dec 23, 2020·Annals of Neurology·Francesco CavallieriElena Moro
Jan 30, 2021·Movement Disorders : Official Journal of the Movement Disorder Society·Seong Ho JeongPhil Hyu Lee
May 12, 2021·Journal of the Neurological Sciences·Asif ButtRichard Camicioli

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