[Neuroprotective effect of dopamine agonists].
Neuroprotection in Parkinson's disease is defined as halting or slowing of the progression of neurodegeneration. Neuroprotective properties of dopamine agonists may be mediated via several mechanisms, (levodopa-sparing effect, decreased dopamine turnover, antioxidant activity or inhibition of the subthalamic nucleus). Many preclinical studies demonstrate that bromocriptine, pergolide, pramipexole, ropinirole and other dopamine agonists provide significant protection against neuronal loss in experimental models. Only a few studies have investigated the potential neuroprotective effect of dopamine agonists at the clinical level. Several recent trials have used neuroimaging biomarkers to assess the rate of dopamine neuron loss in dopamine agonist-treated versus levodopa-treated patients using fluoro-dopa PET or beta-CIT SPECT. Ropinirole slowed the decline of putaminal dopamine storage capacity and pramipexole reduced decline in striatal beta-CIT uptake to a similar extent, compared to levodopa. It is not possible to exclude, however, some pharmacologic or pharmacodynamic effects of drugs on imaging markers in these studies, as well as symptomatic effects of dopamine agonist treatment in clinical outcomes.
Szczudlik
Andrzej
A
Klinika Neurologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. szczudlik@neuro.cm-uj.krakow.pl
Rudzińska
Monika
M
D000818:Animals; D015415:Biomarkers; D002986:Clinical Trials as Topic; D003342:Corpus Striatum / Q000187:drug effects; D018491:Dopamine Agonists / Q000494:pharmacology*; D006801:Humans; D007980:Levodopa / Q000494:pharmacology*; D018696:Neuroprotective Agents / Q000494:pharmacology*; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy*; D049268:Positron-Emission Tomography; D011699:Putamen / Q000187:drug effects; D020531:Subthalamic Nucleus / Q000187:drug effects*; D015899:Tomography, Emission-Computed, Single-Photon
D015415:Biomarkers; D018491:Dopamine Agonists; D018696:Neuroprotective Agents; D007980:Levodopa