Mood fluctuations in Parkinson's disease: a pilot study comparing the effects of intravenous and oral levodopa administration.
OBJECTIVE
Parkinson's disease (PD) is associated with motor fluctuations that have been shown to improve when stable plasma levodopa levels are achieved with continuous levodopa infusions. Many patients also develop mood fluctuations. In this pilot study, we gathered preliminary information about the relationship between changing mood states and plasma levodopa levels.


METHODS
Six patients with idiopathic PD and histories of motor and mood fluctuations participated in a double-blind levodopa infusion study. Subjects received active oral carbidopa/levodopa and a placebo levodopa infusion on one day and placebo oral carbidopa/levodopa and an active levodopa infusion on the other day, in a randomly determined order. Evaluations included serial plasma levodopa levels and assessments of mood and motor states.


RESULTS
Only 4 of the 6 subjects demonstrated mood fluctuations on at least one of the treatment days. All subjects achieved more stable plasma levodopa levels on the active infusion day. Two subjects experienced fewer mood fluctuations on the active infusion day and two experienced fewer on the oral day. Conclusions The results of this pilot study suggest that the relationship between mood state and plasma levodopa level may vary among PD patients.
Richard
Irene Hegeman
IH
Departments of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Irene_Richard@urmc.rochester.edu
Frank
Samuel
S
LaDonna
Kori A
KA
Wang
Hongkun
H
McDermott
Michael P
MP
Kurlan
Roger
R