Evaluation of the Efficacy of Pramipexole for Treating Levodopa-induced Dyskinesia in Patients with Parkinson's Disease
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概要
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Objective The long-term use of levodopa to treat Parkinson's disease (PD) is often limited by the development of motor complications (e.g. levodopa-induced dyskinesia, LID). We hypothesized that a non-ergot dopamine agonist with strong affinity for D3 dopamine receptors (pramipexole) may improve LID in patients taking an ergot D1/D2 dopamine agonist. Methods Patients with PD and LID being treated with levodopa in addition to an ergot dopamine agonist were randomized to either a group in which pramipexole was added to current medications or a group in which the ergot dopamine agonist was switched to pramipexole. Dyskinesia was evaluated using Core Assessment Program for Surgical Interventional Therapies scores. The Unified Parkinson's Disease Rating Scale scores, Modified Hoehn and Yahr stages (at 'on' time), Parkinson's Disease Questionnaire-39 scores and Clinical Global Impression-Improvement scores were also used for evaluation. Results At 24 weeks, pramipexole alleviated LID with more efficiency in the switch group. Conclusion Pramipexole may be a therapeutic option for treating LID because its effects on D3 dopamine receptors may balance the D1 dopamine receptor supersensitivity associated with LID.
著者
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Kano Osamu
Department of Neurology, Toho University Omori Medical Center
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Okuma Yasuyuki
Department Of Neurology Juntendo University Shizuoka Hospital
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Kubo Shin-ichiro
Department Of Neurology Juntendo University School Of Medicine
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Hashida Hideji
Department Of Neurology Graduate School Of Medicine The University Of Tokyo
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Tomimitsu Hiroyuki
Department Of Neurology And Neurological Science Graduate School Of Medical And Dental Sciences Toky
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Hattori Nobutaka
Department Of Neurology Juntendo University School Of Medicine
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Suzuki Yutaka
Division Of Neurology Department Of Medicine Nihon University School Of Medicine
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Suzuki Masahiko
Department Of Applied Chemistry Faculty Of Science Science University Of Tokyo
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Murakami Hidetomo
Department Of Neurology Showa University Fujigaoka Hospital
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Utsumi Hiroya
Department of Neurology, Tokyo Medical University, Japan
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Nanri Kazunori
Department of Neurology, Tokyo Medical University Hachioji Medical Center
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Iijima Mutsumi
Department of Neurology, Tokyo Women's Medical University, Japan
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Matsumura Miyuki
Department of Neurology, Institute of Geriatrics, Tokyo Women's Medical University, Japan
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Iijima Mutsumi
Department of Neurology, Tokyo Women's Medical University, Japan
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Iijima Mutsumi
Department of Neurology, Tokyo Women's Medical University
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Matsumura Miyuki
Department of Neurology, Institute of Geriatrics, Tokyo Women's Medical University, Japan
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Kano Osamu
Department of Neurology, The Methodist Neurological Institute, Weill Cornell Medical College
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Tomimitsu Hiroyuki
Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Japan
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