ABSTRACT
Idiopathic Parkinson's disease induces alterations both motor and cognitive. Levodopa, the treatment of choice, offers initial improvement, but causes long term important complications. It is ignored if it provokes or not a similar situation in cognitive function. Two groups of idiopathic parkinsonian patients were studied. One of them was using levodopa as a regular treatment, the other had de novo patients. A group of healthy controls was also studied. The levodopa group was evaluated when levodopa plasma concentration was maximum and when it was minimum. A cognitive battery was used in order to assess the cognitive status of all subjects. RESULTS: Significant differences between the two groups of patients and the healthy controls were found when the treated group had a maximum plasmatic concentration of levodopa. There were also significant differences when they had a minimum concentration in comparison with the healthy controls. The performances of the patients taking levodopa varied between both conditions...(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Antiparkinson Agents/adverse effects , Cognition Disorders/chemically induced , Levodopa/adverse effects , Parkinson Disease/drug therapyABSTRACT
Introducción. La enfermedad de Parkinson idiopática causa alteraciones tanto en el plano motor como en el cognitivo. La levodopa, fármaco de primera elección para su tratamiento, aunque introduce mejorías motoras inciales, provoca importantes complicaciones a largo plazo. Se desconoce si en el plano cognitivo se produce o no una situación similar. Método. Se estudiaron dos grupos de pacientes con enfermedad de Parkinson idiopática que se diferenciaban sólo por la ingestión o no de levodopa y un grupo de controles sanos. A los tres grupos se les aplicó una batería de diferentes pruebas cognitivas en las condiciones de máxima y mínima concentración plasmática del fármaco. Resultados. Se encontraron diferencias significativas entre los dos grupos de pacientes y los controles sanos cuando el grupo medicado tenía una máxima concentración plasmática de levodopa; igualmente hubo diferencias significativas cuando tenía una mínima concentración en comparación con los controles sanos. Además, las evoluciones de los pacientes medicados con levodopa variaban entre sí de una condición a otra. Conclusiones. La enfermedad de Parkinson provoca alteraciones sobre una amplia variedad de funciones cognitivas, lo que relaciona los ganglios basales con una función más general dentro de la cognición humana relativa al aprendizaje, almacenamiento y suministro a la corteza cerebral de programas motores y cognitivos. La levodopa ejerce un efecto diferente sobre distintas funciones cognitivas, pudiendo incluso fluctuar los beneficios que provoca entre los períodos de máxima y mínima concentración plasmática del fármaco. En algunas funciones aisladas puede causar empeoramiento cuando su concentración es máxima. Este hecho llama la atención acerca de que el uso prolongado de la levodopa puede introducir fluctuaciones más drásticas en el funcionamiento cognitivo general del paciente (AU)
Subject(s)
Middle Aged , Male , Humans , Female , Levodopa , Cognition Disorders , Antiparkinson Agents , Parkinson Disease , Neuropsychological TestsABSTRACT
INTRODUCTION: Idiopathic Parkinson's disease induces alterations both motor and cognitive. Levodopa, the treatment of choice, offers initial improvement, but causes long term important complications. It is ignored if it provokes or not a similar situation in cognitive function. METHOD: Two groups of idiopathic parkinsonian patients were studied. One of them was using levodopa as a regular treatment, the other had de novo patients. A group of healthy controls was also studied. The levodopa group was evaluated when levodopa plasma concentration was maximum and when it was minimum. A cognitive battery was used in order to assess the cognitive status of all subjects. RESULTS: Significant differences between the two groups of patients and the healthy controls were found when the treated group had a maximum plasmatic concentration of levodopa. There were also significant differences when they had a minimum concentration in comparison with the healthy controls. The performances of the patients taking levodopa varied between both conditions. CONCLUSIONS: Parkinson's disease provokes a wide variety of cognitive alterations, therefore basal ganglia can be related to a more general function as learning and storing cognitive and motor programs. Levodopa influences in a different way different cognitive functions differently and its influence varies between highest and lowest plasmatic concentrations periods. These results allow us to draw important conclusions about the cognitive alterations caused by the natural course of Parkinson's disease, the introduction of treatment with levodopa and the relationship between basal ganglia and human cognition.
