Subjective Perceived Motor Improvement after Acute Levodopa Challenge in Parkinson's Disease.
Previous studies found a poor association between parkinsonian patient's reported subjective improvement after commencing dopaminergic treatment and improvements in objective measures of motor impairment by clinician.



To compare PD patient's subjective perceived motor improvement after acute levodopa challenge test with objective motor improvement assessed by the clinician using the UPDRS part III. To analyze clinical characteristics, i.e. age, disease duration, cognitive performance or severity of axial features, that may have influenced patient's perception.



Fifty-seven consecutive PD patients (23 women, 34 men; mean age, 63.4±7.7 years) (Hoehn and Yahr off score, 2.5±0.7; mean disease duration, 11.4±4.1 years) completed the acute levodopa challenge. The percentage of improvement in motor disability, i.e. objective motor improvement, was determined with respect to the off-drug condition.



Bland & Altman visual analysis reveals a high degree of correlation between objective and subjective perceived motor improvement. Both the axial sub-scores in the off- and on-state (respectively, P = 0.006 and P = 0.024) and the presence of peak-dose dyskinesia (P = 0.043) significantly influence the difference between objective and subjective perceived motor improvement.



This is the first study reporting on how PD patients assessed their motor improvement after acute levodopa challenge. These findings suggest a strong correlation between objective motor improvement assessed by the clinician using the UPDRS part III and subjective perceived motor improvement reported by the patient.
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Constance
C
Rabel
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Floriane
F
Le Goff
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Romain
R
Lefaucheur
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Gulden
G
Ozel
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Damien
D
Fetter
Department of Neurology, Rouen University Hospital and University of Rouen, France.
Audrey
A
Rouillé
Department of Neurology, Rouen University Hospital and University of Rouen, France.|INSERM U1073, Rouen, France.
David
D
Maltête
D000368:Aged; D015259:Dopamine Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D000071066:Patient Reported Outcome Measures
D015259:Dopamine Agents; D007980:Levodopa
Parkinson’s disease; acute levodopa challenge; motor improvement; subjective perception