New strategies in the management of Parkinson's disease: a biological approach using a phospholipid precursor (CDP-choline).
CDP-choline, an intermediate in the phospholipid metabolic pathway supposed to improve the functionality of the dopamine (DA) system, was administered to parkinsonian patients in a double-blind cross-over study versus placebo. All patients were already treated with L-dopa + dopa decarboxylase inhibitor. Clinical evaluations were carried out using the Webster Rating Scale (WRS), the Northwestern University Disability Scale (NUDS) and a semiquantitative rating scale for tremor, rigidity and bradykinesia. CDP-choline treatment showed a significant improvement of rigidity and bradykinesia and a less important amelioration of tremor. NUDS and WRS showed a similar positive result. Comparing the results obtained by placebo, we found that the actual clinical efficacy of CDP-choline regards mainly bradykinesia and rigidity (23 and 33% improvement, respectively). The positive effect of CDP-choline on parkinsonian patients already treated with L-dopa + dopa decarboxylase inhibitor stands for a possible action on the DA receptor through an activation of the phospholipid metabolism.
D000328:Adult; D000368:Aged; D001545:Benserazide / Q000627:therapeutic use; D002230:Carbidopa / Q000627:therapeutic use; D002794:Choline / Q000031:analogs & derivatives*; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D011954:Receptors, Dopamine / Q000187:drug effects*
D011954:Receptors, Dopamine; D007980:Levodopa; D003566:Cytidine Diphosphate Choline; D001545:Benserazide; D002230:Carbidopa; D002794:Choline