Entacapone reduces cortical activation in Parkinson's disease with wearing-off: a f-MRI study.
OBJECTIVE
Wearing-off is one of the most frequent problems encountered by levodopa-treated patients. Entacapone, a peripheral inhibitor of catechol-O-methyltransferase (COMT), reduces this motor complication by prolonging the effect of levodopa. We sought to understand the impact of COMT-inhibition on movement execution in PD patients with wearing-off by comparing functional magnetic resonance imaging (f-MRI) activation patterns prior to and during entacapone treatment. Our hypothesis was to determine whether changes in cortical activation are associated to COMT-inhibitor treatment.


METHODS
Nine levodopa-treated non-demented PD patients with wearing-off were prospectively studied in two f-MRI session, prior to and during entacapone treatment. A group of control subjects were also studied for comparison.


RESULTS
The patients significantly improved under COMT-inhibitor treatment based on home diaries. F-MRI results showed that at baseline the patients presented a bilateral activation of the primary motor, controlateral premotor cortex and supplementary motor area, as well as ipsilateral cerebellum. During treatment with entacapone, PD patients showed reductions in the activations of these cortical areas and a decreased activation in the ipsilateral cerebellum.


CONCLUSIONS
Our preliminary findings indicate that f-MRI is able to detect cortical activation changes during long-term modulation of dopaminergic treatment in PD patients with wearing-off, and thus, this technique could be further investigated in advanced PD patients.
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Nicola
N
Tambasco
Servizio di Fisica Sanitaria, Azienda Ospedaliera di Terni, Terni, Italy.
Marco
M
Muti
Servizio di Neuroradiologia, Azienda Ospedaliera di Perugia, Perugia, Italy.
Pietro
P
Chiarini
Servizio di Fisica Sanitaria, Azienda Ospedaliera di Perugia, Perugia, Italy.
Roberto
R
Tarducci
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Stefano
S
Caproni
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Anna
A
Castrioto
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Pasquale
P
Nigro
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Lucilla
L
Parnetti
Servizio di Neuroradiologia, Azienda Ospedaliera di Perugia, Perugia, Italy.
Pietro
P
Floridi
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
Aroldo
A
Rossi
Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy; I.R.C.C.S. - Fondazione S.Lucia, Roma, Italy.
Paolo
P
Calabresi
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D065098:Catechol O-Methyltransferase Inhibitors / Q000627:therapeutic use*; D002396:Catechols / Q000627:therapeutic use*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009570:Nitriles / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D065098:Catechol O-Methyltransferase Inhibitors; D002396:Catechols; D009570:Nitriles; C071192:entacapone