Acute vs chronic effects of l-dopa on bladder function in patients with mild Parkinson disease

Brusa, Livia; Petta, Filomena; Pisani, Antonio; Moschella, Vincenzo; Iani, Cesare; Stanzione, Paolo; Miano, Roberto; Finazzi‐Agrò, Enrico

doi:10.1212/01.wnl.0000260605.12506.86

Cited by 68 publications

(26 citation statements)

References 24 publications

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“…18,19 These findings must be evaluated carefully, due to the limitations of our study to assess the impact of medications on the voiding function. In a recent study, Brusa et al 20 evaluated the effects of chronic levodopa treatment on the bladder function of PD patients. They showed improvement of filling (irritative) symptoms as well as improved bladder capacity and bladder sensation.…”

Section: Discussionmentioning

confidence: 99%

Voiding dysfunction in patients with Parkinson's disease: Impact of neurological impairment and clinical parameters

Sammour

Gomes

Barbosa

et al. 2009

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

Voiding dysfunction in patients with Parkinson's disease: Impact of neurological impairment and clinical parameters

Sammour

Gomes

Barbosa

et al. 2009

Neurourology and Urodynamics

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“…In drug naïve patients urodynamic findings may worsen after levodopa treatment, but after chronic administration there is usually improvement in bladder dysfunction. 776 Detrusor hypoactivity or urethral sphincter dysfunction are less common causes of urinary dysfunction, but may occur in patients with PD with autonomic failure. If daytime frequency or urgency precedes nocturia, mechanical outlet obstruction should be excluded.…”

Section: Impulse Dyscontrol and Dopamine Dysregulation Disordersmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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“…Die Therapie mit dopaminergen Substanzen scheint neben dem bekannten Effekt auf die motorischen Symptome auch einen positiven Effekt auf die Funktion des UHT zu haben, wobei sich dieser Effekt erst nach dauerhafter Gabe von L-Dopa einzustellen scheint [11,73].…”

Section: Funktionsstörungen Des Uht Bei Mpunclassified

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Mehnert

Nehiba

2012

Urologe

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The lower urinary tract (LUT) is regulated by a complex neural network that is subject to supraspinal control. Neurological disorders, especially of the central nervous system (CNS), can rapidly lead to disruption of this control. Multiple sclerosis, Parkinson's disease, multiple system atrophy, and stroke are neurological disorders which quite frequently cause dysfunction of the LUT. With respect to the pathophysiology of bladder dysfunction in CNS diseases there are various hypotheses regarding the individual disorders: disturbances of neural communication between the frontal cortex and pontine micturition center, between the pontine micturition center and the lumbosacral parts of the spinal cord, and between the basal ganglia, thalamus, and anterior cingulate gyrus appear to play a pivotal role in the development of bladder dysfunction. The symptoms and urodynamic presentation of LUT dysfunction can vary considerably depending on the disease and disease progression and can change in the course of the disease. The incidence and prevalence of LUT dysfunctions rise with increasing progression of the underlying neurological disease.Various conservative, minimally invasive, and open surgical procedures are available to prevent harmful sequelae and to improve the quality of life of these patients. As yet, however, few data exist on most of the treatment options in cases of the above-mentioned CNS diseases. Intermittent self-catheterization and antimuscarinic medications are among the most important conservative treatment options. Injection of botulinum neurotoxin type A into the detrusor muscle and increasingly sacral or pudendal neuromodulation are among the most important minimally invasive treatment options. Surgical methods include reconstructive continent or incontinent urinary diversion.When planning therapy the patient's current needs and neurological limitations as well as possible disease progression must be taken into consideration. It is often advisable to consult with and enlist the cooperation of the attending neurologist when planning treatment.

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Acute vs chronic effects of l-dopa on bladder function in patients with mild Parkinson disease

Abstract: The acute and chronic l-dopa effects may be due to the different synaptic concentrations or to the activation of postsynaptic mechanisms obtained by chronic administration.

Cited by 68 publications

References 24 publications

Voiding dysfunction in patients with Parkinson's disease: Impact of neurological impairment and clinical parameters

Voiding dysfunction in patients with Parkinson's disease: Impact of neurological impairment and clinical parameters

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

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