Quantitative study of salivary secretion in Parkinson's disease.
We examined basal and reflex salivary flow rate and composition in 46 patients with Parkinson's disease (PD), both in off and on conditions, compared to 13 age-matched controls without underlying disease or treatment affecting autonomic function. Whole saliva was collected 12 hours after withdrawal of dopaminergic drugs and at the peak of levodopa-induced motor improvement. Twenty-three of the 46 PD patients had received domperidone a week before the study. Basal salivary flow rate was significantly lower in PD patients in the off state compared to controls (P<0.005). Levodopa increased salivary flow rate (P<0.05) both in the domperidone-pretreated and untreated groups. Citric acid stimulated salivary flow rate in both the off and on states in PD patients. This effect was higher in the domperidone-pretreated patients. Salivary concentration of sodium, chloride, and amylase was higher in PD patients than in controls and was not affected by levodopa or domperidone treatment. Levodopa stimulates both basal and reflex salivary flow rate in PD. The mechanism appears to be central, as the effect is not blocked by domperidone. Domperidone may have a peripheral effect that potentiates reflex salivary secretion. Salivary composition is abnormal in PD and is not affected by levodopa treatment.
Tumilasci
Omar R
OR
Departamento de Fisiología, Laboratorio de Neurofisiología, Facultad de Medicina, and Programa de Parkinson y Movimientos Anormales, Instituto de Neurociencias del Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina.
Cersósimo
M G
MG
Belforte
Juan E
JE
Micheli
Federico E
FE
Benarroch
Eduardo E
EE
Pazo
Jorge H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000378:metabolism; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000097:blood / Q000627:therapeutic use; D016022:Case-Control Studies; D004294:Domperidone / Q000008:administration & dosage; D018492:Dopamine Antagonists / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007980:Levodopa / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D012146:Rest / Q000502:physiology; D012472:Salivation / Q000502:physiology*; D012636:Secretory Rate / Q000187:drug effects / Q000502:physiology*
D000978:Antiparkinson Agents; D018492:Dopamine Antagonists; D007980:Levodopa; D004294:Domperidone; D000681:Amylases