Reversibility of Upper Airway Obstruction after Levodopa Therapy in Parkinson's Disease

Vincken, Walter; Darauay, Carmen; Cosio, Manuel G.

doi:10.1378/chest.96.1.210

Cited by 70 publications

(33 citation statements)

References 9 publications

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“…One report, however, described that subcutaneous injections of apomorphine, a powerful direct dopamine receptor agonist, induced a statistically significant increase of MIP and MEP in 10 patients with PD (HY 2 to 4) 4 . There is also a single case report which described the reversibility of upper airway obstruction in a patient with PD after using levodopa 16 . On the contrary, Weiner et al 15 observed MIP and MEP comparing off and on periods in 20 patients with PD.…”

Section: Discussionmentioning

confidence: 99%

“…These results suggest that nigrostriatal dysfunction is at least partly responsible for the decrease of respiratory pressure in patients with PD 4 . There are few publications in literature concerning the effect of levodopa on MIP and MEP 15,16 . The aim of this study was to determine MIP and MEP in patients with PD, comparing these values with those found in matched-controls and to evaluate the effect of levodopa administration over these variables.…”

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confidence: 99%

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Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

Guedes

Rodrigues²,

Fernandes

et al. 2012

Arq. Neuro-Psiquiatr.

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OBJECTIVE: To investigate the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in patients with Parkinson's disease (PD) during the on and off periods of levodopa and to compare with healthy controls. METHODS: Twenty-six patients were analyzed with Hoehn and Yahr scores (2-3) and 26 age and gender matched-controls. Statistical analysis was performed with Student's t-test for paired and independent samples. RESULTS: MIP and MEP values in patients were significantly lower than the values obtained in controls both for off and on stages -excepted for MIP in women (p=0.28). For patients with PD, the studied parameters did not differ between stages on and off, with the exception of MEP in women (p=0.00). CONCLUSIONS: Patients with PD have respiratory pressure lower than controls, even in early stages of the disease, and dopamine replacement has little impact over these respiratory pressures. These findings suggest that respiratory changes in PD may be unrelated to dopaminergic dysfunction.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

Guedes

Rodrigues²,

Fernandes

et al. 2012

Arq. Neuro-Psiquiatr.

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“…By contrast, generalized airflow obstruction due to a previously suggested excessive parasympathetic activity [11] does not appear to be a characteristic finding in patients with PD. Since antiparkinsonian drugs may dramatically reverse respiratory abnormalities [25], it remains possible that without treatment ventilatory defects might have been more important.…”

Section: Discussionmentioning

confidence: 99%

Airway dysfunction in patients with Parkinson's disease

Alonso

Jiménez-Jiménez

Cabrera‐Valdivia

et al. 1994

Lung

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To investigate pulmonary function abnormalities in Parkinson's disease (PD), we obtained maximal inspiratory and expiratory flow-volume curves in 63 patients (59 under treatment) with different stages of the disease, not filtered for respiratory symptoms. PD severity was evaluated by the Unified PD Rating Scale, the Webster's scale, and Hoehn and Yahr staging. Patients with more severe PD had lower percentage forced vital capacity (FVC%), and peak inspiratory and expiratory flows. Those with fluctuations and/or dyskinesias had lower FVC% and percentage forced expiratory flow volume in 1 sec (FEV1%). There were a number of weak but significant correlations between PD scales and spirographic parameters. Thirty one patients (49.2%) had pathological flow-volume curves. The clinical profile and the duration of the disease did not influence the pattern of the curve. Physiologic evidence of upper airway obstruction was observed in 3 cases. A spirometric restrictive ventilatory defect (FEV1/FVC higher than or equal to 80%) was observed in 54 patients (85%), while generalized airway obstruction was present only in one nonsmoker. We conclude that abnormal flow-volume loop contour is a frequent finding in PD. This probably reflects involvement of the upper airway musculature, that in some patients can produce upper airway obstruction. Generalized airflow limitation is not an important characteristic of PD. By contrast, a restrictive spirometric defect, probably due to incoordinated expiratory effort or abnormally low chest wall compliance, is the main spirometric finding in these patients.

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“…Evidence of UA obstruction on spirometry during wakefulness was found in 24-65 % of PD patients, which could be secondary to rigidity and hypokinesia [10,11]. This might predispose these patients to UA obstruction at night, hence, increasing the risk of OSA.…”

Section: Introductionmentioning

confidence: 99%

“…Previous groups have shown an improvement of UA obstruction on spirometry following levodopa intake [11,12]. Considering that UA obstruction is a contributing mechanism to OSA and the possible impact of the latter on NMS and quality of life, we wanted to assess the effect of levodopa on OSA.…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea in Parkinson’s disease patients: effect of Sinemet CR taken at bedtime

et al. 2015

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Reversibility of Upper Airway Obstruction after Levodopa Therapy in Parkinson's Disease

Cited by 70 publications

References 9 publications

Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

Airway dysfunction in patients with Parkinson's disease

Obstructive sleep apnea in Parkinson’s disease patients: effect of Sinemet CR taken at bedtime

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