Arena J E, Cerquetti D, Rossi M, Chaves H, Rollan C, Dossi D E, Merello M
Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
Department of Radiology, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
Parkinsonism Relat Disord. 2016 Mar;24:126-8. doi: 10.1016/j.parkreldis.2016.01.017. Epub 2016 Jan 20.
To determine whether brain white matter hyperintensities (WMH) influence l-dopa response in Parkinson's disease (PD) patients.
We prospectively evaluated 60 PD patients with an acute l-dopa challenge test, and assessed motor performance with the Movement Disorders Society revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) during "ON" and "OFF" medication states. Magnetic resonance images were examined using a visual semi-quantitative rating scale for quantification and distribution analysis of WMH. l-dopa challenge test response was correlated to extent and location of WMH, to determine a potential association between them.
Subjects with greater deep WMH burden, showed less response to l-dopa on axial motor symptoms (R = -0.35; p < 0.027), when tested with Part III of the MDS-UPDRS before and after acute levodopa challenge.
Results suggest WMH may affect response to l-dopa on axial function of PD patients, which could be due to either non-dopaminergic (cortico-basal ganglia) motor pathway disruption, or postsynaptic nigrostriatal pathway involvement.
确定脑白质高信号（WMH）是否影响帕金森病（PD）患者对左旋多巴的反应。
我们对60例PD患者进行了急性左旋多巴激发试验，并在药物“开”和“关”状态下，使用运动障碍协会修订的统一帕金森病评定量表（MDS-UPDRS）评估运动表现。使用视觉半定量评定量表检查磁共振图像，以对WMH进行量化和分布分析。将左旋多巴激发试验反应与WMH的程度和位置相关联，以确定它们之间的潜在关联。
在急性左旋多巴激发前后，使用MDS-UPDRS第三部分进行测试时，深部WMH负担较重的受试者在轴向运动症状方面对左旋多巴的反应较小（R = -0.35；p < 0.027）。
结果表明，WMH可能会影响PD患者轴向功能对左旋多巴的反应，这可能是由于非多巴胺能（皮质-基底神经节）运动通路破坏或突触后黑质纹状体通路受累所致。
