Introduction to Dopaminergic Therapy

In view of limited disease modifying therapies to slow or revert disease progression in FTD, an important approach could consist in targeting the neurotransmitter deficits, similarly to what has been achieved in Parkinson's disease with dopaminergic therapy or Alzheimer's disease with cholinergic therapy.

In our study, we validated the additional value of 123I-MIBG scintigraphy beyond providing information on neurological findings and response to dopaminergic therapy for the diagnosis of PDin the early phase.

Further adjustment for changes in dopaminergic therapy and SMM yielded consistent results: mean difference, 18.

Methods Drug-naïve Parkinson’s disease patients and Parkinson’s disease patients treated with dopaminergic therapy, neurological controls, schizophrenic patients treated with antidopaminergic therapy, and drug-naïve schizophrenic patients were recruited for the study and CSF was collected.

The aim of this study was to investigate the seed-based DMN connectivity and the influence of dopaminergic therapy on the DMN integrity in non-demented PD by using resting-state fMRI.

Motor/non-motor fluctuations and dyskinesia are common serious late effects of dopaminergic therapy in PD.

RAS likely remains underdiagnosed and according to IRLSSG diagnostic criteria RAS should be considered when RLS-like symptoms are present in one or both arms, especially when they have a circadian pattern and are improved by movement and dopaminergic therapy.

Background: Schizophrenia is a severe mental disorder, usually treated with long-term anti-dopaminergic therapy.

PD patients were evaluated twice, both under their usual dopaminergic therapy (ON) and after a medication washout period of 12 hours (OFF).

,1 one crucial variable is dopaminergic therapy, as emergence of RLS after STN DBS in patients with PD has been reported after abrupt decrease of dopaminergic treatment.

Dopaminergic therapy further weakened the sustained response in both groups.

It remains unclear which PD non-motor symptoms are dependent on the dopaminergic deficit, are related to nondopaminergic systems, or are due to the dopaminergic therapy [6, 7].

As the disease progresses, patients are prone to expose dopaminergic therapy induced complications including motor fluctuations, levodopa-induced dyskinesia, and impulse control disorders (ICDs) (1).

EnglishDespite lack criteria about the start of dopaminergic therapy in Parkinson's disease, it must be begun in the onset quality of life impairment.

Dear Editor, Three patients with relatively young-onset levodopa-responsive Parkinson’s disease (PD) underwent subthalamic (STN) deep brain stimulation (DBS) surgery for the management of severe motor response complications following oral dopaminergic therapy.

Introduction: Deep brain stimulation of the subthalamic nucleus (STN-DBS) ameliorates motor function in patients with Parkinson's disease and allows reducing dopaminergic therapy.

Certain temporal parameters (cadence, cycle time, and swing time) were nonresponsive to the dopaminergic therapy.

This case series of cystic prolactinomas demonstrates the successful use of transsphenoidal surgery as a favorable, and a potentially curative alternative to dopaminergic therapy in this patient population.

Significance l-Dopa–induced dyskinesia (LID) is a major complication of dopaminergic therapy in Parkinson’s disease.

CONCLUSIONS Phase-amplitude coupling and distributed coherence are cortical biomarkers of the Parkinsonian state that are detectable noninvasively, and may be useful as objective aids for management of dopaminergic therapy.

Limited dopaminergic therapy responses implicate non-dopaminergic mechanisms calling for alternative therapies.

Further research might identify subgroups of patients with stroke who could benefit from dopaminergic therapy at different doses or times after stroke with more intensive motor therapy.

Levodopa/carbidopa ES was generally well tolerated in this patient population, with adverse events (AEs) associated with aging, advanced PD-related comorbidities, the procedure/device or dopaminergic therapy.

Second, dopaminergic therapy improved this deficit, such that choices in patients ON medication were indistinguishable from controls.

Treatment can be divided into strategies for preventing their occurrence, modification of dopaminergic therapy, and providing more continuous dopaminergic stimulation as well as the use of nondopaminergic drugs.

Augmentation, a treatment-induced paradoxical worsening of the symptoms of restless legs syndrome (RLS) that is caused by long-term dopaminergic therapy, in particular with higher doses, remains the major challenge of RLS treatment.

1 This underscores the controversy surrounding this issue since there are reports of RLS emergence after DBS in patients with PD with greater reduction of dopaminergic therapy,3 less reductions,2 and no correlation with degree of medication reduction.

The classic presentation is characterized by early severe postural instability with falls, axial Parkinsonism that usually does not respond to dopaminergic therapy, and supranuclear vertical gaze palsy.

Although certain cardinal features of parkinsonism, including bradykinesia and rigidity, respond well to levodopa, axial features, such as gait and balance impairment, are less reliably responsive to dopaminergic therapy and surgical interventions.

The discovery of dopamine inhibitory effects on prolactin secretion has led to an era of successful dopaminergic therapy for prolactinomas.

Expert opinion: In Parkinson’s disease, depression may benefit from the optimization of dopaminergic therapy, from the use of antidepressants acting on both the serotoninergic and noradrenergic pathways and from cognitive behavioral therapy.

ABSTRACT Background: Deep brain stimulation (DBS) is effective for treatment of motor complications of dopaminergic therapy in Parkinson’s disease (PD) but occasionally has been associated with multidomain cognitive decline.

Increased PD duration, severity, depression or anxiety symptoms, and doses of dopaminergic therapy were significantly associated with poor sleep quality.

Most NMS have a poor response to dopaminergic therapy as it is due to dysfunction of the serotonergic and noradrenergic pathways.

An almost identical syndrome, Parkinson-hyperpyrexia syndrome, can result from abrupt reduction or withdrawal of dopaminergic therapy in Parkinson’s disease patients.