Influence of Dietary Protein on Motor Fluctuations in Parkinson's Disease

Pincus, Jonathan H.; Barry, Kathryn

doi:10.1001/archneur.1987.00520150026014

Cited by 87 publications

(72 citation statements)

References 17 publications

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“…It has been reported that the L-dopa efficacy in parkinsonian patients increases by low protein diet (Nutt et al, 1984;Pincus and Barry, 1987a;Eriksson et al, 1988;Tsui et al, 1989;Carter et al, 1989). L-dopa is a family of large neutral amino acids.…”

Section: Discussionmentioning

confidence: 99%

“…It is common experience that dietary protein affects the efficacy of L-dopa (Mena and Cotzias, 1975;Nutt et al, 1984;Pincus and Barry, 1987a;Eriksson et al, 1988;Carter et al, 1989). However, it is very difficult to carry out a double-blind study in which highand low-protein diets are prepared to be identical in appearance and taste (Tsui et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

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Rotations induced by L-dopa in parkinsonian rats are reduced by an ingestion of amino acids

Mizuta

Kuno

1993

J Neural Transm Gen Sect

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We studied the effect of amino acid load on L-dopa-induced rotational behavior in rats with unilateral lesion of the nigrostriatal pathway. Pretreatment of rats with an ingestion of high concentration of amino acids significantly reduced the number of rotations induced by subcutaneously injected L-dopa. These results provide the experimental basis for clinical observations that dietary protein affects the response to L-dopa in parkinsonian patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rotations induced by L-dopa in parkinsonian rats are reduced by an ingestion of amino acids

Mizuta

Kuno

1993

J Neural Transm Gen Sect

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“…To avoid this problem, some have recommended a protein redistribution diet in which all dietary proteins are consumed during the evening so that the patient can enjoy a better motor response during the day. 486 However, the benefits obtained with dietary manipulation are short term, the diet is unpleasant, and a dietician should be involved to assure that minimum daily protein requirements are met. A more practical approach is simply to administer levodopa on an empty stomach 1 hour before or 1 hour after each meal.…”

Section: Pharmacologic Management Of Advanced Pd Patientsmentioning

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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“…Therefore, although limiting the protein intake significantly improves the motor disabilities and the sensitivity to levodopa in some patients by reducing LNAA plasma levels, a high-protein diet can cause a dramatic worsening of motor performance in the same patients (Berry et al, 1991;Pincus & Barry, 1987a, 1987b, 1987cWajsbort, 1977). In fact, as we have seen previously, motor performance correlated with LNAA, not with levodopa, absorption, and blood concentrations (Carter et al, 1989;Tsui et al, 1989).…”

Section: Levodopa and Dietary Proteinmentioning

confidence: 99%