Central acute D2 stimulation worsens bladder function in patients with mild Parkinson's disease.
OBJECTIVE
The different roles of D1 and D2 dopamine receptors in LUT behavior have been demonstrated in animal studies. In particular D2 selective agonists and D1 selective antagonists seem to produce a reduction of the bladder capacity in conscious rats. This finding has never been confirmed in human studies. Thus, in this study we investigated the role of D1 and D2 agonists/antagonists on LUT behavior in patients with PD.


METHODS
A total of 87 patients with mild PD were evaluated. Patients were evaluated with urodynamic studies (cystometry followed by a pressure flow study with perineal floor electromyography) performed in off status and after oral administration of 250 mg of LD. In 70 patients a third urodynamic evaluation was conducted in one of the following conditions: after simultaneous administration of 250 mg oral LD and 60 or 120 mg oral domperidone (D2 peripheral antagonist); after simultaneous administration of 250 mg oral LD and 25, 50 or 150 mg intramuscular L-sulpiride (D2 central and peripheral antagonist). Several urodynamic parameters were evaluated and results obtained in different conditions compared.


RESULTS
LD alone worsened detrusor overactivity: in particular, a reduction of first urinary sensation, involuntary detrusor contraction threshold (reflex volume) and bladder capacity was observed. L-sulpiride (central and peripheral D2 antagonist) coadministration counteracted the worsening in a dose dependent manner. Domperidone (peripheral D2 antagonist) coadministration failed to determine the same counteraction.


CONCLUSIONS
According to our results, a central acute D2 stimulation seems to be responsible of a reduction of bladder capacity with worsening of detrusor overactivity in patients with mild PD.
Brusa
Livia
L
Department of Neurology, University of Rome Tor Vergata, Rome, Italy.
Petta
Filomena
F
Pisani
Antonio
A
Miano
Roberto
R
Stanzione
Paolo
P
Moschella
Vincenzo
V
Galati
Salvatore
S
Finazzi Agrò
Enrico
E
D004294:Domperidone / Q000494:pharmacology*; D018492:Dopamine Antagonists / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D012720:Severity of Illness Index; D013469:Sulpiride / Q000494:pharmacology*; D001743:Urinary Bladder / Q000187:drug effects* / Q000503:physiopathology*
D018492:Dopamine Antagonists; D004294:Domperidone; D013469:Sulpiride