Fetoni V, Genitrini S, Monza D, Soliveri P, Testa D, Caraceni T, Girotti F
Istituto Nazionale Neurologico C. Besta, Milan, Italy.
Clin Neuropharmacol. 1997 Jun;20(3):239-44. doi: 10.1097/00002826-199706000-00008.
The purpose of this study was to quantitatively compare the motor response to L-dopa in Parkinson's disease (PD) and striatonigral-type multisystem atrophy (MSA) patients. Ten consecutive MSA patients were compared with nine PD patients selected to have similar overall motor compromise, age, and mental state. The performance of simple repetitive axial movements plus bilateral proximal and distal limb movements; overall motor response assessed by the Unified Parkinson Disease Rating Scale (UPDRS); as well as scores from the UPDRS items evaluating speech/facial expression, postural stability, and posture/gait were assessed 90 min and 12 h (baseline) after L-dopa administration. The total UPDRS score, all subcategory scores, and all body movements improved significantly in the PD group. Proximal and distal limb akinesias and speech/facial expression improved in some MSA patients. Lack of response of axial akinesia to L-dopa in MSA correlates with a presumed greater loss of postsynaptic dopaminergic receptors in the dorsolateral putamen, while improvement in distal and proximal limb muscle akinesias in MSA patients may be related to relative preservation of the ventral putamen.
本研究的目的是定量比较帕金森病（PD）患者和纹状体黑质型多系统萎缩（MSA）患者对左旋多巴的运动反应。将连续的10例MSA患者与9例经挑选的具有相似总体运动功能损害、年龄和精神状态的PD患者进行比较。在给予左旋多巴后90分钟和12小时（基线），评估简单重复性轴向运动以及双侧近端和远端肢体运动的表现；通过统一帕金森病评定量表（UPDRS）评估总体运动反应；以及来自UPDRS中评估言语/面部表情、姿势稳定性和姿势/步态项目的得分。PD组的UPDRS总分、所有子类别得分以及所有身体运动均有显著改善。部分MSA患者的近端和远端肢体运动不能以及言语/面部表情有所改善。MSA患者轴向运动不能对左旋多巴无反应与背外侧壳核中假定更大程度的突触后多巴胺能受体丧失相关，而MSA患者远端和近端肢体肌肉运动不能的改善可能与腹侧壳核的相对保留有关。
