Levodopa response in dementia with lewy bodies: A 1-year follow-up study.

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Levodopa response in dementia with lewy bodies: A 1-year follow-up study.

7/6/2010

Abstract

PURPOSE: To evaluate levodopa responsiveness in patients with probable dementia

with Lewy bodies (DLB) compared to early Parkinson's disease (PD) patients.

METHODS: Twenty four cases with DLB and 21 with PD underwent a baseline

assessment with UPDRS (sub-item II and III) and an acute levodopa challenge

test. Positive response to acute levodopa test was defined as an improvement of

at least 15% in the tapping test, and at least 25% in the walking test and

rigidity or tremor score. Subsequently, all patients were treated continuously

with levodopa and evaluated after 6 and 12 months by means of UPDRS II/III.

RESULTS: Positive response to the acute levodopa test was observed in 55% of DLB

patients (acute DLB responders), and in 90% of PD patients (acute PD

responders). Acute DLB responders showed increased latency, and reduction of

both duration and amplitude of response to acute levodopa in comparison with

acute PD responders. At the 6-month follow-up visit, acute DLB responders showed

a greater motor benefit compared with acute DLB non-responders. This improvement

was similar to that observed in PD patients. However, at 1-year follow-up acute

DLB responders showed a faster worsening of UPDRS III scores compared with acute

PD responders, implying a reduction of levodopa efficacy.

CONCLUSIONS: Positive response to acute levodopa test can occur in DLB patients

and may be predictive of long-term benefit of chronic levodopa therapy, although

the motor improvement is less impressive than in PD patients. Copyright © 2010.

Published by Elsevier Ltd.

Source:

http://www.ncbi.nlm.nih.gov/pubmed/20615745