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THUR 117 The L-DOPA response in pathologically confirmed parkinson’s disease
  1. Vanessa Pitz1,
  2. Naveed Malek2,
  3. Katherine A Grosset1,3,
  4. Donald G Grosset1,3
  1. 1Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
  2. 2Department of Neurology, Ipswich Hospital NHS Trust, Ipswich, UK
  3. 3Department of Neurology, Queen Elizabeth University Hospital, Glasgow, UK

Abstract

Background l-dopa is the standard treatment for Parkinson’s disease, but the response is variable.

Aim Systematic review of papers reporting the l-dopa response (motor response and/or complications) in pathologically confirmed Parkinson’s disease.

Results 467 cases of pathologically confirmed Parkinson’s were identified: 60.2% male, age at disease onset 63.3 years (SD 10.3), age at death 76.7 years (SD 7.8). Data on a graded l-dopa response were available in 411 cases (88.0% of 467). The motor response was excellent in 148/411 cases (36.0%), good in 179/411 (43.6%), moderate in 51/411 (12.4%) and poor/absent in 33/411 (8.0%). Data about motor complications were available for 161 patients: 71/161 (44.1%) had motor fluctuations and 89/161 (55.3%) had dyskinesia. Comorbid brain pathology was evaluated in 251/411 cases (61.1%), and was present in 148/251 (59.0%): cerebrovascular in 65/148 (43.9%), Alzheimer’s in 55/148 (37.2%), amyloid angiopathy in 18/148 (12.2%), and diffuse Lewy body disease in 10/148 (6.8%). Data linking the graded l-dopa response to comorbid pathologies were available in only 17 cases, of whom 8/17 (47.1%) had a good/excellent response.

Conclusion There is variation in the l-dopa response in pathologically confirmed Parkinson’s disease. The limited available information suggests a possible association of motor response to comorbid brain pathology.

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