Langston J W, Ballard P
Can J Neurol Sci. 1984 Feb;11(1 Suppl):160-5. doi: 10.1017/s0317167100046333.
Our experience in treating 7 patients with moderate to severe parkinsonism induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is reviewed. Virtually all of the problems typically encountered with dopamine precursor and agonist therapy in treating Parkinson's disease have been observed during a one and one half year follow-up period, including "end-of-dose" deterioration (or "wearing off"), "peak-dose" dyskinesias, "on-off" phenomena, and psychiatric complications. These have occurred much earlier than is typically seen when treating the idiopathic disease. This rapid evolution of therapeutic side-effects favors the view that at least some of the complications of dopamine precursor therapy may be related to severity of disease rather than the length of levodopa therapy. Finally, we suggest that the occurrence of this full array of therapeutic complications in patients with MPTP-induced parkinsonism furthers the analogy between this syndrome ane Parkinson's disease.
我们回顾了治疗7例由1-甲基-4-苯基-1,2,3,6-四氢吡啶（MPTP）诱发的中度至重度帕金森综合征患者的经验。在为期一年半的随访期内，几乎观察到了多巴胺前体和激动剂治疗帕金森病时通常会遇到的所有问题，包括“剂末”恶化（或“疗效减退”）、“峰剂量”运动障碍、“开-关”现象以及精神并发症。这些情况比治疗特发性帕金森病时通常出现的时间要早得多。治疗副作用的这种快速演变支持了这样一种观点，即多巴胺前体治疗的至少一些并发症可能与疾病严重程度有关，而不是与左旋多巴治疗的时长有关。最后，我们认为MPTP诱发的帕金森综合征患者出现这一系列治疗并发症，进一步加深了该综合征与帕金森病之间的相似性。
