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Long term treatment and disease severity change brain responses to levodopa in Parkinson’s disease

¹ Department of Psychiatry, Washington University School of Medicine, USA
² Department of Radiology, Washington University School of Medicine
³ Department of Neurology, Washington University School of Medicine
⁴ Department of Anatomy and Neurobiology, Washington University School of Medicine

Correspondence to:
Correspondence to:
Dr J S Perlmutter, Campus Box 8225,4525 Scott Avenue, St Louis, MO 63110, USA;
joel{at}npg.wustl.edu

Methods: Positron emission tomography (PET) measurements were used of brain-blood flow before and after an acute dose of levodopa in three groups: PD patients treated long term with levodopa without levodopa induced dyskinesias, levodopa naive PD patients, and controls.

Results: It was found that the PD group treated long term responded to acute levodopa differently from controls in left sensorimotor and left ventrolateral prefrontal cortex. In both regions, the treated PD group had decreased blood flow whereas the control group had increased blood flow in response to levodopa. Levodopa naive PD patients had little or no response to levodopa in these regions. Within the treated PD group, severity of parkinsonism correlated with the degree of abnormality of the sensorimotor cortex response, but not with the prefrontal response.

Conclusions: It is concluded that long term levodopa treatment and disease severity affect the physiology of dopaminergic pathways, producing altered responses to levodopa in brain regions associated with motor function.

Keywords: Parkinson’s disease; cerebral blood flow; dopamine; levodopa; positron emission tomography

Abbreviations: PD, Parkinson’s disease; PET, positron emission tomography

This article has been cited by other articles:

				S. Hirano, K. Asanuma, Y. Ma, C. Tang, A. Feigin, V. Dhawan, M. Carbon, and D. Eidelberg Dissociation of Metabolic and Neurovascular Responses to Levodopa in the Treatment of Parkinson's Disease J. Neurosci., April 16, 2008; 28(16): 4201 - 4209. [Abstract] [Full Text] [PDF]