Document Detail


Management of motor complications in Parkinson disease: current and emerging therapies.
MedLine Citation:
PMID:  20816270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Motor fluctuations and dyskinesias are common motor complications that manifest within the first few years from the initiation of therapy in patients with Parkinson disease. These complications negatively affect the quality of life and represent an important source of disability. A growing number of therapeutic options including treatments aimed at prolonging the efficacy of levodopa (eg, selective monoamine oxidase-B inhibitors and catechol-O-methyltransferase inhibitors), administration of longer-acting dopamine agonists (eg, rotigotine, sustained-release ropinirole), and continuous administration of intraduodenal levodopa exist or will soon become available. Patients who maintain a good response to levodopa but continue to experience disabling motor complications despite the best medical management may benefit from a regimen of subcutaneous apomorphine, ideally delivered by a subcutaneous pump, or deep-brain stimulation of the subthalamic nucleus or internal portion of the pallidum. Emerging therapies for motor complications are expected to further enhance continuous (physiologic) delivery of dopaminergic drugs and extend the reach of therapies beyond the dopaminergic system to influence not only the motor but also the vast range of nonmotor complications of this multisystemic disease.
Authors:
Alberto J Espay
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurologic clinics     Volume:  28     ISSN:  1557-9875     ISO Abbreviation:  Neurol Clin     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8219232     Medline TA:  Neurol Clin     Country:  United States    
Other Details:
Languages:  eng     Pagination:  913-25     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurology, James J. and Joan A. Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati Neuroscience Institute, 260 Stetson Street, Suite 2300, PO Box 670525, Cincinnati, OH 45267-0525, USA. alberto.espay@uc.edu
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MeSH Terms
Descriptor/Qualifier:
Deep Brain Stimulation
Dopamine Agonists / therapeutic use
Dyskinesias / complications,  physiopathology,  therapy*
Humans
Levodopa / therapeutic use
Parkinson Disease / complications,  physiopathology,  therapy*
Chemical
Reg. No./Substance:
0/Dopamine Agonists; 0/Levodopa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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