Daily dose of dopaminergic medications in Parkinson disease: Clinical correlates and a posteriori equation

Objectives: To survey daily doses of dopaminergic medications and to draw a posteriori equation of the dose in relation to the various clinical variables in Korean patients with Parkinson disease. Methods: A multi-center cross-sectional survey was conducted over a defi ned period. Information on patient demographics and clinical features including age at Parkinson disease onset, disease duration, treatment duration and Hoehn and Yahr stage, and daily doses of anti-parkinsonian drugs was obtained from the patients’ medical records. Results: A total of 1,762 patients with Parkinson disease were recruited from 6 referral centers. The mean L-dopa equivalent daily dose (LEDD) in the whole population was 608.9 mg/day, which tended to increase linearly depending on the duration of disease and Hoehn and Yahr stage. LEDD was also signifi cantly affected by age and gender. We performed multiple linear regression analyses and devised a posteriori equation of LEDD with clinical variables. Conclusions: This survey provides systematic data for mean LEDD in Korean Parkinson disease patients. In spite of profound individual variations in LEDD, our linear regression model provides an insight about the relationship between daily doses of dopaminergic medications and various clinical features of Parkinson disease.

[1]  K. Østergaard,et al.  Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus , 2006, Movement disorders : official journal of the Movement Disorder Society.

[2]  M. Contin,et al.  Levodopa pharmacokinetics and dyskinesias: are there sex-related differences? , 2003, Neurological Sciences.

[3]  Sheng-Huang Lin,et al.  NEUROPSYCHOLOGICAL EFFECTS AFTER CHRONIC SUBTHALAMIC STIMULATION AND THE TOPOGRAPHY OF THE NUCLEUS IN PARKINSON'S DISEASE , 2007, Neurosurgery.

[4]  M. Contin,et al.  Effect of age on the pharmacokinetics of oral levodopa in patients with Parkinson's disease , 2004, European Journal of Clinical Pharmacology.

[5]  W. Oertel,et al.  Pharmacotherapy of Parkinson’s disease in Germany , 2005, Journal of Neurology.

[6]  D. Inzitari,et al.  Parkinson's disease and parkinsonism in a longitudinal study: two-fold higher incidence in men. ILSA Working Group. Italian Longitudinal Study on Aging. , 2000, Neurology.

[7]  J. Saint-Cyr,et al.  Long-term follow up of bilateral deep brain stimulation of the subthalamic nucleus in patients with advanced Parkinson disease. , 2003, Journal of neurosurgery.

[8]  D. Grosset,et al.  Proposed dose equivalence for rapid switching between dopamine agonists in Parkinson's disease. , 2006, Clinical therapeutics.

[9]  J. Kuratsu,et al.  Effect of bilateral subthalamic nucleus stimulation on levodopa-unresponsive axial symptoms in Parkinson’s disease , 2008, Acta Neurochirurgica.

[10]  A. Lees Alternatives to Levodopa in the Initial Treatment of Early Parkinson’s Disease , 2005, Drugs & aging.

[11]  D. Woitalla,et al.  The Management Approaches to Dyskinesia Vary from Country to Country , 2007, Neuroepidemiology.

[12]  R. Mosteller Simplified calculation of body-surface area. , 1987, The New England journal of medicine.

[13]  A. Benabid,et al.  Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. , 2003, The New England journal of medicine.

[14]  M M Cohen,et al.  Pharmacotherapy of Parkinson's disease. , 1977, American journal of hospital pharmacy.

[15]  Mosteller Rd Simplified Calculation of Body-Surface Area , 1987 .

[16]  L. Wilkins Zonisamide improves motor function in Parkinson disease: A randomized, double-blind study , 2007, Neurology.

[17]  A. Lang,et al.  Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group. , 2002, JAMA.

[18]  D. Inzitari,et al.  Parkinson’s disease and parkinsonism in a longitudinal study , 2000, Neurology.

[19]  J. Obeso,et al.  Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up. , 2005, Brain : a journal of neurology.

[20]  J. Hughes,et al.  Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[21]  S. Paek,et al.  ELECTRODE POSITION DETERMINED BY FUSED IMAGES OF PREOPERATIVE AND POSTOPERATIVE MAGNETIC RESONANCE IMAGING AND SURGICAL OUTCOME AFTER SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION , 2008, Neurosurgery.