Stocchi Fabrizio
Department of Neurology, IRCCS San Raffaele Pisana, Rome, Italy.
Neurol Sci. 2008 Dec;29 Suppl 5:S383-6. doi: 10.1007/s10072-008-1053-8.
In the parkinsonian patient, the striatal levels of dopamine strictly depend on peripheral levodopa levels; short half-life of levodopa is responsible for plasmatic level fluctuations, which are consistent with a pulsatile receptor stimulation of the striatal system. This sort of non-physiologic stimulation induces a change of the condition of post-synaptic neurons, which is considered responsible for the fluctuations of clinical response. In this respect, apomorphine administration, via infusion pump, may be a good therapeutic option, aimed at obtaining continuous receptor stimulation, assisting in the management of motor fluctuations in the advanced phase of the disease.
在帕金森病患者中,纹状体多巴胺水平严格依赖于外周左旋多巴水平;左旋多巴的短半衰期导致血浆水平波动,这与纹状体系统的脉冲式受体刺激一致。这种非生理性刺激会引起突触后神经元状态的改变,这被认为是临床反应波动的原因。在这方面,通过输液泵给予阿扑吗啡可能是一种很好的治疗选择,旨在实现持续的受体刺激,有助于管理疾病晚期的运动波动。