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Deterioration in parkinsonism with low-dose pergolide
1Walton Centre for Neurology and Neurosurgery, Fazakerley, Liverpool, UK.
Journal of Neurology
|June 15, 1999
Summary
Dopamine agonists may help early Parkinson's disease, but some patients experience worsening symptoms at low doses. This study explores the reasons behind this paradoxical motor deterioration.
Area of Science:
- Neurology
- Neuroscience
- Pharmacology
Background:
- Dopamine agonists are used early in Parkinson's disease to delay levodopa-related motor complications.
- Gradual dose escalation of dopamine agonists is advised to minimize side effects.
Observation:
- Some Parkinson's patients exhibit a decline in motor function at low dopamine agonist doses.
- Symptom improvement is noted as the dopamine agonist dosage increases in these patients.
Findings:
- This phenomenon, termed 'reverse tolerance' or 'diaschisis', suggests complex dopaminergic system adaptations.
- The study investigates the underlying mechanisms of this paradoxical motor response.
Implications:
- Understanding this response could lead to optimized dopamine agonist dosing strategies.
- Further research into dopaminergic pathways may reveal new therapeutic targets for Parkinson's disease.