title: The Effect of L-Dopa/Carbidopa Intestinal Gel in Parkinson Disease Assessed Using Neurophysiologic Techniques.
abstract: BACKGROUND
  By providing a stable and smooth L-dopa plasmatic level, L-dopa/carbidopa intestinal gel reproduces the physiological continuous dopaminergic receptor stimulation in patients with Parkinson disease (PD), and it therefore represents a suitable tool to investigate the role of the altered dopaminergic neurotransmission in the pathophysiology of motor and sensory abnormalities in this condition.
  
  
  METHODS
  We studied 11 patients with advanced PD being treated with L-Dopa/carbidopa intestinal gel (LCIG) and 11 age-matched healthy subjects. Bradykinesia was measured by kinematic recording of repetitive finger movements (finger tapping), whereas sensory abnormalities were evaluated using the somatosensory tactile discrimination threshold. All the patients were studied off and on medication, in 2 different experimental sessions.
  
  
  RESULTS
  Parkinson disease patients were very slow and hypokinetic during finger tapping, with no progressive reduction in amplitude or speed being observed during movement repetition. Somatosensory temporal discrimination threshold values were higher in PD patients than in healthy subjects. The neurophysiologic assessment of the effects of LCIG in advanced PD patients demonstrates an improvement, although not normalization, of motor and sensory abnormalities.
  
  
  CONCLUSIONS
  The study provides an objective evaluation of the effects of LCIG on motor and sensory abnormalities in PD. The results suggest that besides dopaminergic mechanisms motor and sensory abnormalities in PD reflect a varying combination of pathophysiologic mechanisms.
authors.affiliation: *Neuromed Institute IRCCS, Pozzilli; and †Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bologna
authors.forename: Anna
authors.initials: A
authors.lastname: Latorre
authors.forename: Francesca
authors.initials: F
authors.lastname: Di Biasio
authors.forename: Antonella
authors.initials: A
authors.lastname: Conte
authors.forename: Daniele
authors.initials: D
authors.lastname: Belvisi
authors.forename: Nicola
authors.initials: N
authors.lastname: Modugno
authors.forename: Antonio
authors.initials: A
authors.lastname: Suppa
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fabbrini
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage*; D016022:Case-Control Studies; D004338:Drug Combinations; D005260:Female; D005782:Gels; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000502:physiology; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D009485:Neuroradiography / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000187:drug effects; D012684:Sensory Thresholds / Q000187:drug effects; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D005782:Gels; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa