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Plasma levodopa peak delay and impaired gastric emptying in Parkinson's disease.
MedLine Citation:
PMID:  22632782     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Whereas delayed gastric emptying is believed to be a causative factor for producing delayed-on and motor fluctuation in Parkinson's disease (PD), few studies have directly measured levodopa pharmacodynamics and gastric emptying together. In order to determine the relationship, we measured these two parameters in a single PD patients cohort. METHODS: Thirty-one patients with PD were enrolled in the study. They were 11 men and 20 women; age, 68.1±7.8years; disease duration, 4.2±3.8years; Unified Parkinson's Disease Rating Scale Part 3 Motor Score 18.37±8.60; bowel movement <3 times a week in 20; all taking 301mg±94mg/day levodopa/carbidopa. All patients underwent levodopa pharmacokinetic study and the gastric emptying study using (13)C-octanoic acid expiration breath test. Statistical analysis was performed by Student's t-test and Mann-Whitney's U test. RESULTS: Pharmacokinetic study showed that the plasma levodopa peak was at 2hours in 42% (13/31 patients) whereas at 1hour in 58% (18/31 patients), total of 50.7±16.4min (mean±standard deviation) in all 31 patients. The gastric emptying study showed that T(max) ((13)C)>60min was more common in patients with a plasma levodopa peak at 2hours (14/18, 69%) than in those with a plasma levodopa peak at 1hour (4/13, 22%) (p<0.05), total of 50.7±16.4min in all 31 patients. CONCLUSION: We found a significant relationship between levodopa pharmacokinetics and gastric emptying in PD patients, suggesting that delayed gastric emptying is a causative factor for producing delayed-on in PD. Therefore, studies of improved gastric emptying in order to ameliorate delayed-on in PD are warranted.
Authors:
Hirokazu Doi; Ryuji Sakakibara; Mitsutoshi Sato; Tohru Masaka; Masahiko Kishi; Akihiko Tateno; Fuyuki Tateno; Yohei Tsuyusaki; Osamu Takahashi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-24
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  -     ISSN:  1878-5883     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier B.V. All rights reserved.
Affiliation:
Pharmaceutical Unit, Sakura Medical Center, Toho University, Sakura, Japan.
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