Systematic review of levodopa dose equivalency reporting in Parkinson's disease

Tomlinson, Claire L; Stowe, Rebecca; Patel, Smitaa; Rick, Caroline; Gray, Richard; Clarke, Carl E

doi:10.1002/mds.23429

Cited by 3,682 publications

(2,697 citation statements)

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“…Thus, patients with mood and/or cognitive disorders could be excluded or test results could be correlated with FER outcomes. Likewise, knowing the clear influence of DRT on FER, future studies should take into account the LED calculated for each patient according to common guidelines110 or enrolled patients not receiving medication yet or assessed off medication. At last, as far as disease duration/severity is concerned, more sensitive markers should be privileged.…”

Section: Discussionmentioning

confidence: 99%

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

et al. 2018

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Parkinson's disease is a neurodegenerative disorder classically characterized by motor symptoms. Among them, hypomimia affects facial expressiveness and social communication and has a highly negative impact on patients' and relatives' quality of life. Patients also frequently experience nonmotor symptoms, including emotional‐processing impairments, leading to difficulty in recognizing emotions from faces. Aside from its theoretical importance, understanding the disruption of facial emotion recognition in PD is crucial for improving quality of life for both patients and caregivers, as this impairment is associated with heightened interpersonal difficulties. However, studies assessing abilities in recognizing facial emotions in PD still report contradictory outcomes. The origins of this inconsistency are unclear, and several questions (regarding the role of dopamine replacement therapy or the possible consequences of hypomimia) remain unanswered. We therefore undertook a fresh review of relevant articles focusing on facial emotion recognition in PD to deepen current understanding of this nonmotor feature, exploring multiple significant potential confounding factors, both clinical and methodological, and discussing probable pathophysiological mechanisms. This led us to examine recent proposals about the role of basal ganglia‐based circuits in emotion and to consider the involvement of facial mimicry in this deficit from the perspective of embodied simulation theory. We believe our findings will inform clinical practice and increase fundamental knowledge, particularly in relation to potential embodied emotion impairment in PD. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionmentioning

confidence: 99%

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

et al. 2018

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“…Of special interest were daily doses of levodopa (LDD); for other dopaminergic drugs, daily levodopa equivalent doses (LEDD) were calculated (Grosset, Needleman, Macphee, & Grosset, 2004; Tomlinson et al., 2010). In order to investigate whether both groups were comparable with regard to their dopaminergic demand, for LCIG patients current LDD/LEDD as well as the latest LDD/LEDD before starting LCIG treatment were obtained.…”

Section: Methodsmentioning

confidence: 99%

Effects of levodopa/carbidopa intestinal gel versus oral levodopa/carbidopa on B vitamin levels and neuropathy

et al. 2017

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ObjectivesTo determine the possible interactions between levodopa therapy and plasma levels of B vitamins in patients with advanced idiopathic Parkinson's disease (IPD) in the context of either oral levodopa therapy or levodopa/carbidopa intestinal gel (LCIG). Secondly, to determine the prevalence of neuropathy and its relation to plasma levels of B vitamins and homocysteine.MethodsMedication doses, neurographies, and serum levels of pyridoxine, cobalamin, folate, and homocysteine of eight LCIG and 13 orally treated advanced IPD patients matched for age, Hoehn & Yahr stage, and UPRDS III were collected. This data was analyzed for correlation with daily levodopa dose (LDD).Results LICG patients had a longer disease duration and higher LDD. All LCIG patients and most orally treated patients had sensorimotor axonal polyneuropathy. Of all plasma vitamin levels, pyridoxine was decreased most and significantly lower in the LCIG group. Cobalamin and folate, however, were within the lower reference range, and homocysteine highly elevated, all without any significant difference between both groups. LDD correlated significantly with pyridoxine deficiency (p = .02) irrespective of the route of application and with hyperhomocysteinemia in the LCIG group (p = .03). At LDDs above 2,000 mg, pyridoxine deficiency was almost always detectable.ConclusionsPyridoxine deficiency and hyperhomocysteinemia are dependent on the daily levodopa/carbidopa dose, while levels of cobalamin and folate are not. The mode of application of levodopa/carbidopa has no impact on B‐vitamin levels. Neuropathy is very frequent in advanced IPD; however, it remains to be investigated further whether neuropathy is more frequent in LCIG than in orally levodopa/carbidopa‐treated advanced IPD patients.

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“…L‐DOPA equivalent dose (LED) was calculated using a formula reported by Tomlinson et al. (2010). The differences in medication dosage between baseline and 2‐year follow‐up are expressed as ΔLED.…”

Section: Methodsmentioning

confidence: 99%

The factors associated with impulse control behaviors in Parkinson's disease: A 2‐year longitudinal retrospective cohort study

et al. 2018

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IntroductionImpulse control behaviors (ICBs) are impulsive–compulsive behaviors often associated with dopamine replacement therapy in Parkinson's disease (PD). Although remission can occur in ICB, only four reports on the ratio of remission and the persistence of ICB have been published, and the associated factors with ICB remission or persistence have been little known. Therefore, we conducted a longitudinal assessment of the remission, persistence, and development of ICB and those associated factors in patients with PD.MethodsWe retrospectively investigated a PD database at Aomori Prefectural Central Hospital, Japan. One hundred and forty‐eight patients with PD who could be followed up for 2 years were enrolled. ICB was assessed using the Questionnaire for Impulsive–Compulsive Disorders in Parkinson's disease. Motor severity (Hoehn and Yahr scale and United Parkinson's Disease Rating Scale), cognitive function (Mini–Mental State Examination), and other clinical variables (sex, age, onset age, disease duration, olfactory dysfunction, and dyskinesia) and medications used to treat PD were assessed. Univariate analyses were performed.ResultsSeven patients were excluded because of the exclusion criteria, and 141 patients were analyzed. Thirty patients (21.3%) had ICB at baseline, and these patients also had significantly higher use of pergolide. The ICB remission rate was 60%, the ICB persistence ratio was 40%, and the ICB development ratio was 12.6% over 2 years. Statistically, younger age and pergolide use were associated with ICB persistence. Being male, having dyskinesia, and rotigotine, entacapone, zonisamide, and istradefylline use were associated with ICB development.ConclusionThis study suggests that younger age and pergolide use may be the new associated factors with ICB persistence and that entacapone, zonisamide, and istradefylline use may be associated with the development of ICB. Drug profiles and medication practices in Japan may explain the association of these factors with ICB.

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Systematic review of levodopa dose equivalency reporting in Parkinson's disease

Cited by 3,682 publications

References 58 publications

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

Facial emotion recognition in Parkinson's disease: A review and new hypotheses

Effects of levodopa/carbidopa intestinal gel versus oral levodopa/carbidopa on B vitamin levels and neuropathy

The factors associated with impulse control behaviors in Parkinson's disease: A 2‐year longitudinal retrospective cohort study

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