title: Influence of white matter MRI hyper-intensities on acute l-dopa response in patients with Parkinson's disease.
abstract: OBJECTIVE
  To determine whether brain white matter hyperintensities (WMH) influence l-dopa response in Parkinson's disease (PD) patients.
  
  
  METHODS
  We prospectively evaluated 60 PD patients with an acute l-dopa challenge test, and assessed motor performance with the Movement Disorders Society revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) during "ON" and "OFF" medication states. Magnetic resonance images were examined using a visual semi-quantitative rating scale for quantification and distribution analysis of WMH. l-dopa challenge test response was correlated to extent and location of WMH, to determine a potential association between them.
  
  
  RESULTS
  Subjects with greater deep WMH burden, showed less response to l-dopa on axial motor symptoms (R = -0.35; p < 0.027), when tested with Part III of the MDS-UPDRS before and after acute levodopa challenge.
  
  
  CONCLUSIONS
  Results suggest WMH may affect response to l-dopa on axial function of PD patients, which could be due to either non-dopaminergic (cortico-basal ganglia) motor pathway disruption, or postsynaptic nigrostriatal pathway involvement.
authors.affiliation: Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: J E
authors.initials: JE
authors.lastname: Arena
authors.affiliation: Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: D
authors.initials: D
authors.lastname: Cerquetti
authors.affiliation: Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Department of Radiology, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: H
authors.initials: H
authors.lastname: Chaves
authors.affiliation: Department of Radiology, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Rollan
authors.affiliation: Department of Neurology, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina.
authors.forename: D E
authors.initials: DE
authors.lastname: Dossi
authors.affiliation: Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research FLENI, Buenos Aires, Argentina; Argentina National Scientific and Technological Research Council (CONICET), Buenos Aires, Argentina. Electronic address: mmerello@fleni.org.ar.
authors.forename: M
authors.initials: M
authors.lastname: Merello
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D066127:White Matter / Q000000981:diagnostic imaging* / Q000187:drug effects*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Levodopa; Parkinson's disease; White matter disease