Acute stepwise challenge test with levodopa in treated patients with parkinsonism. 2009

Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. happyfym@gmail.com

OBJECTIVE The aim of this study was to establish a new stepwise type of acute challenge test with incremental doses of levodopa/benserazide, and verify its predictive value in follow-up diagnoses and outcomes of deep-brain stimulation (DBS) in treated patients with parkinsonism. METHODS Prospective cohort study. RESULTS The optimal cutoff points for UPDRS-III improvement in these stepwise levodopa tests. In this study, we established acute challenge tests with incremental doses of levodopa/benserazide (100/25mg, 150/37.5mg, 200/50mg and 300/75 mg) in treated patients with parkinsonism (n=175). The receiver operating characteristic (ROC) curves were plotted to compare peak UPDRS-III improvement of PD patients (n=112) with that of non-PD parkinsonism patients (n=63). The point on the ROC curve with the highest Youden index was defined as the optimal cutoff point in motor improvement for differential diagnoses. The results of the new tests were compared with follow-up diagnoses and the outcomes of DBS. RESULTS The optimal cutoff points for UPDRS-III improvement with maximal Youden Indices on ROC curves from the tests, with the four incremental doses of levodopa/benserazide, were 12.2% (100/25mg), 22.3% (150/37.5mg), 27.9% (200/50mg) and 33.4% (300/75 mg). The test showed significant correlation with follow-up diagnosis and the outcomes of DBS (P of Kappa <0.01). CONCLUSIONS The results suggested that the new acute stepwise levodopa challenge test is a useful tool for the diagnosis of PD.

UI MeSH Term Description Entries
D007980 Levodopa The naturally occurring form of DIHYDROXYPHENYLALANINE and the immediate precursor of DOPAMINE. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to DOPAMINE. It is used for the treatment of PARKINSONIAN DISORDERS and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. L-Dopa,3-Hydroxy-L-tyrosine,Dopaflex,Dopar,L-3,4-Dihydroxyphenylalanine,Larodopa,Levopa,3 Hydroxy L tyrosine,L 3,4 Dihydroxyphenylalanine,L Dopa
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010300 Parkinson Disease A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75) Idiopathic Parkinson Disease,Lewy Body Parkinson Disease,Paralysis Agitans,Primary Parkinsonism,Idiopathic Parkinson's Disease,Lewy Body Parkinson's Disease,Parkinson Disease, Idiopathic,Parkinson's Disease,Parkinson's Disease, Idiopathic,Parkinson's Disease, Lewy Body,Parkinsonism, Primary
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003710 Demography Statistical interpretation and description of a population with reference to distribution, composition, or structure. Demographer,Demographic,Demographic and Health Survey,Population Distribution,Accounting, Demographic,Analyses, Demographic,Analyses, Multiregional,Analysis, Period,Brass Technic,Brass Technique,Demographers,Demographic Accounting,Demographic Analysis,Demographic Factor,Demographic Factors,Demographic Impact,Demographic Impacts,Demographic Survey,Demographic Surveys,Demographic and Health Surveys,Demographics,Demography, Historical,Demography, Prehistoric,Factor, Demographic,Factors, Demographic,Family Reconstitution,Historical Demography,Impact, Demographic,Impacts, Demographic,Multiregional Analysis,Period Analysis,Population Spatial Distribution,Prehistoric Demography,Reverse Survival Method,Stable Population Method,Survey, Demographic,Surveys, Demographic,Analyses, Period,Analysis, Demographic,Analysis, Multiregional,Demographic Analyses,Demographies, Historical,Demographies, Prehistoric,Distribution, Population,Distribution, Population Spatial,Distributions, Population,Distributions, Population Spatial,Family Reconstitutions,Historical Demographies,Method, Reverse Survival,Method, Stable Population,Methods, Reverse Survival,Methods, Stable Population,Multiregional Analyses,Period Analyses,Population Distributions,Population Methods, Stable,Population Spatial Distributions,Prehistoric Demographies,Reconstitution, Family,Reconstitutions, Family,Reverse Survival Methods,Spatial Distribution, Population,Spatial Distributions, Population,Stable Population Methods,Technic, Brass,Technique, Brass
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females

Related Publications

Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
January 2021, Neurology India,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
January 2000, European neurology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
April 1977, Archives of neurology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
October 1972, Archives of neurology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
January 2024, Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
October 1979, Archives of neurology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
January 1983, Journal of neural transmission. Supplementum,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
October 1973, Archives of neurology,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
October 2021, Acta neurologica Belgica,
Tao Feng, and Wei Li, and Linlong Lu, and Yilong Wang, and Weixiong Shi, and Jianguo Zhang, and Yongjun Wang, and Piu Chan
January 2017, Movement disorders clinical practice,
Copied contents to your clipboard!