Levodopa treatment of presenile dementia

Abstract

In Parkinson's disease as well as presenile dementia there is a dopamine deficit in the basal ganglia. Extrapyramidal symptoms are common in presenile dementia, and dementia is a common trait in Parkinsonism. It is reasonable to suggest a partial common etiology and pathophysiology, and the logical consequence is an investigation of levodopa substitution is presenile dementia. Until now very few reports of such studies have been published. The investigations have been uncontrolled or carried out on small or inhomogeneous materials. This investigation is triple-blind, clinically controlled, and the material is very homogenous. After 6 months' levodopa treatment no significant effect is shown either on a broad spectrum of psychiatric items or in cognitive functioning. This negative result is discussed. The probability of a specific Parkinson dementia is mentioned and the significance of the modifying effect of an imbalance in other transmitter systems is emphasized.

Levodopa: Faster and better word learning in normal humans

“…10 -12 Some of the cognitive deficits respond to oral treatment with the dopamine precursor L-dopa, at least in the early stages of the disease. [13][14][15][16][17][18] L-Dopa also has been effective in improving learning and memory after stroke and traumatic and hypoxic brain injury. 19 -22 L-Dopa-induced improvement of learning in these conditions has been attributed to a restoration of dopaminergic drive after damage to the mesocortical dopamine system.…”

CSF monoamine metabolites in dementia of the Alzheimer type and controls: Evidence for lower levels of homovanillic acid and 5‐hydroxyindoleacetic acid in patients

“…Attempts to treat these abnormalities with serotonin precursors or uptake inhibitors have not been unequivocal as yet (Meyrer et al, 1977;Smith et al, 1984;Bergman et al, 1983). Attempts to increase dopamine function in DAT with 1-dopa have also resulted in conflicting data (Kristensen et al, 1977;Drachman and Stahl, 1975).…”

Neuropsychologische Aspekte bei idiopathischem Morbus Parkinson

“…Meßbare Verbesserungen ergeben sich sowohl für die Exekutivfunktionen als auch für die mnestischen und räumlich-visuellen Leistungen (47,48,49). Die relativ gute Erholung der kognitiven Funktionen von Parkinson-Patienten unter L-Dopa kann als weiterer Hinweis dafür gewertet werden, daß vor allem subkortikale dopaminerge Mechanismen fiir die Defizite in der intellektuellen Leistungsfähigkeit dieser Patientengruppe verantwortlich sind (50). Die depressiven Verstimmungszustände sprechen hingegen auf eine dopaminerge Behandlung nicht an.…”