Summary
During long-term treatment with L-dopa in Parkinson's syndrome “on-off” phenomenon develops in many cases, often entailing considerable therapeutic problems. Decreased sensitivity in postsynaptic striatal dopamine (DA) receptors has been shown to occur in parkinsonian patients during long-term treatment with L-dopa. This has been suggested as one possible mechanism for development of the “on-off” phenomenon. In contrast to L-dopa treatment electroconvulsions have been shown to increase sensitivity in the DA receptors, when administered to animals.
The antiparkinsonian effect of electroconvulsive therapy (ECT) was investigated in five parkinsonian patients with “on-off” phenomenon, with or without concomitant signs of mental depression. ECT was administered according to praxis in treatment of mental depression. Drug therapy, including L-dopa, was maintained on previously adjusted doses during and after ECT.
A marked improvement in the parkinsonian symptoms as well as in the “on-off” phenomenon occurred in three of the patients, persisting for several months. The other two patients showed only slight and transient improvement.
It thus seems that ECT may be useful as a supplementary treatment in parkinsonian patients with “on-off” phenomenon. The antiparkinsonian effect of ECT is probably mediated by increased sensitivity in postsynaptic DA structures.
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Balldin, J., Edén, S., Granérus, A.K. et al. Electroconvulsive therapy in Parkinson's syndrome with “on-off” phenomenon. J. Neural Transmission 47, 11–21 (1980). https://doi.org/10.1007/BF01256635
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DOI: https://doi.org/10.1007/BF01256635