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Advanced Parkinson's Patients Still Respond to Levodopa

Researchers study long-duration response in patients treated with deep brain stimulation

WEDNESDAY, July 12 (HealthDay News) -- In patients with advanced Parkinson disease, the long-duration response to levodopa remains significant, and subthalamic deep brain stimulation (DBS) compensates for the short-duration response and long-duration response to levodopa, according to a study published in the July issue of the Archives of Neurology.

Christian Wider, M.D., of the University of Lausanne in Lausanne, Switzerland, and colleagues studied 30 Parkinson disease patients who underwent subthalamic DBS. The patients were divided into a no-levodopa group, which had no anti-parkinsonian treatment since surgery, and a levodopa group in which medical treatment was reinitiated.

After six months, the researchers found that the no-levodopa group showed a significantly greater worsening of medication-off Unified Parkinson's Disease Rating Scale motor scores (mean 16.53 points) compared to the levodopa group (mean 5.0 points). They found no significant worsening of medication-on scores in the no-levodopa group (mean 22.05 points) or in the levodopa group (mean 30.41 points).

"This worsening being absent in the levodopa group, it probably reflected the loss of the long-duration response to levodopa in the no-levodopa group," the authors state. "When DBS was turned on, postoperative motor subscale scores of the Unified Parkinson's Disease Rating Scale in both groups were similar to preoperative scores while receiving medication, suggesting that subthalamic DBS compensated for the short-duration response and long-duration response to levodopa."

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