title: Switching L-dopa Therapy from Pulsatile to Pulse Administration Reduces Motor Complications in Parkinson's Disease.
abstract: OBJECTIVE
  To evaluate the severity of wearing-off and dyskinesia in patients with complicated Parkinson disease (PD) after switching L-dopa oral therapy from a "pulsatile" administration, consisting in intermittent multiple daily small doses of the drug, to a "pulse" administration, consisting in standard oral doses given at specific interdose intervals.
  
  
  METHODS
  Thirty-four PD patients with motor complications were monitored twice with standardized waking day motor status evaluations using the Unified Parkinson Disease Rating Scale-Motor Examination (UPDRS-ME) and the Abnormal Involuntary Movement Scale (AIMS) after switching L-dopa administration modality from "pulsatile" to "pulse." To quantify predictable motor fluctuations, a Wearing Off Index was computed based on changes in treatment response magnitude.
  
  
  RESULTS
  On the whole, after switching from "pulsatile" to "pulse" administration, there was a reduction in number of L-dopa daily doses and an increase in the amount of the dosage of the single doses, AIMS maximum score decreased without increasing motor disability. More specifically, in predominant fluctuating patients, there was a significant reduction in UPDRS-ME average score as well as in Wearing Off Index. In predominant dyskinetic patients, there was a significant reduction in average and maximum AIMS scores with no changes in average and maximum UPDRS-ME scores.
  
  
  CONCLUSIONS
  Switching L-dopa therapy from "pulsatile" to "pulse" modality may reduce the severity of wearing-off and dyskinesia in complicated PD.
authors.affiliation: Dipartimento "G.F. Ingrassia", Sezione di Neuroscienze, Università Degli Studi di Catania, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mostile
authors.forename: Alessandra
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Valeria
authors.initials: V
authors.lastname: Dibilio
authors.forename: Antonina
authors.initials: A
authors.lastname: Luca
authors.forename: Loredana
authors.initials: L
authors.lastname: Raciti
authors.forename: Giorgia
authors.initials: G
authors.lastname: Sciacca
authors.forename: Calogero Edoardo
authors.initials: CE
authors.lastname: Cicero
authors.forename: Rosario
authors.initials: R
authors.lastname: Vasta
authors.forename: Giulia
authors.initials: G
authors.lastname: Donzuso
authors.forename: Donatella
authors.initials: D
authors.lastname: Contrafatto
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000188:drug therapy* / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa