Effective treatment of pure akinesia with L-threo-3,4-dihydroxyphenylserine (DOPS): report of a case, with pharmacological considerations.
A patient with pure akinesia, who experienced freezing only when starting to walk backward or when turning, is reported. L-DOPA, maprotiline, clonazepam, DL-threo-3,4-dihydroxyphenylserine (DOPS), and L-threo-DOPS were administered to the patient. Only DL-threo-DOPS and L-threo-DOPS were effective, but they concurrently brought on a hypomanic state. Combining carbidopa with DL (or L)-threo-DOPS did not change the effectiveness of the treatment. DL (or L)-threo-DOPS did not affect monoamine metabolites in the cerebrospinal fluid (CSF). The effectiveness of L-threo-DOPS on freezing, the induction of affective changes, and the absence of 3-methoxy-4-hydroxyphenylglycol alteration in the CSF suggest that L-threo-DOPS acts centrally but may not directly involve the noradrenergic system.
Yamamoto
M
M
Ujike
H
H
Ogawa
N
N
D015103:Droxidopa / Q000627:therapeutic use*; D004576:Electromyography; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008950:MMPI; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D009069:Movement Disorders / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000503:physiopathology; D012694:Serine / Q000031:analogs & derivatives*
D012694:Serine; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D015103:Droxidopa; D006719:Homovanillic Acid