Parkinson's disease and lower limb somatosensory evoked potentials: apomorphine-induced relief of the akinetic-rigid syndrome and vertex P37-N50 potentials.
We evaluated brainstem P30, vertex-central P37-N50 and contralateral frontal N37 somatosensory evoked potentials (SEPs) from the tibial nerve in 14 patients affected by Parkinson's disease (PD) with akinetic-rigid syndrome. In seven patients SEPs were recorded after administration of apomorphine. The cortical P37-N50 complex was either absent (five patients, eight tested sides) or significantly smaller in patients as compared to the control group (n = 18). There was a relationship between abnormalities of early vertex potentials and degree of motor impairment. Administration of apomorphine was followed by an increase in amplitude of P37-N50 response, which was maximal after 15-30 min and then progressively returned to basal values in parallel with clinical improvement. Amplitude of brainstem P30 and frontal N37 responses was within normal values and did not vary following drug administration. These results suggest that the P37-N50 complex arises from independent cortical generators, probably located in the pre-rolandic cortex, which may be selectively affected by basal ganglia dysfunction. Amplitude decrease of the P37-50 complex may reflect an abnormal processing of somatosensory inputs within the pre-central cortex due to defective modulation exerted by basal ganglia circuitry on cortical excitability. SEP potentiation following apomorphine, besides indicating that this dysfunction is partly reversible, might suggest objective method to measure therapeutic efficacy.
Dipartimento di Scienze Neurologiche e della Visione, Sezione di Neurologia, Policlinico Borgo Roma, Verona, Italy.
M
M
Tinazzi
A
A
Fiaschi
D
D
Idone
F
F
Tezzon
G
G
Zanette
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001058:Apomorphine / Q000627:therapeutic use*; D001933:Brain Stem / Q000187:drug effects / Q000503:physiopathology; D004594:Electrophysiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009127:Muscle Rigidity / Q000150:complications / Q000188:drug therapy*; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D013577:Syndrome
D000978:Antiparkinson Agents; D001058:Apomorphine