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Therapieempfehlungen der Früh- und Spätphase der Parkinson-Krankheit

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Neuro-Psychopharmaka Ein Therapie-Handbuch
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Zusammenfassung

Der Parkinson-Krankheit (PK) liegt eine langsam-progressive Degeneration nigraler dopaminerger Neurone zugrunde, welche zu einer Dopamindepletion im Bereich nigrostriataler Afferenzen fÜhrt. Positron-Emissions-Tomographie (PET)-Studien, welche die dopaminerge FunktionstÜchtigkeit nigrostriataler Afferenzen untersuchten, weisen darauf hin, daß die präsymptomatische Krankheitsphase wahrscheinlich weniger als 10 Jahre beträgt. Nach Ablauf dieser Frist, bei der es zu einer mindestens 50%igen Degeneration von dopaminergen Substantia nigra-Neuronen und einer 70–80%igen Dopaminreduktion im Striatum gekommen ist, treten erstmals die PK-typi-schen motorischen Symptome, insbesondere die Trias Akinese, Rigor und Ruhetremor, auf. Im weiteren Verlauf kÖnnen posturale Instabilität, GangstÖrungen, kognitive und psychopathologische Auffälligkeiten sowie vegetative Störungen hinzutreten.

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Literatur

  • Ahlskog JE, Muenter MD, Maraganore DM et al. (1994) Fluctuating Parkinson’s disease: treatment with the long-acting dopamine agonist cabergoline. Arch Neurol 51: 1236–1241

    Article  PubMed  CAS  Google Scholar 

  • Ahlskog JE, Wright KF, Muenter MD, Aller CH (1996) Adjunctive cabergoline therapy of Parkinson’s disease: comparison with placebo and assessment of dose responses and duration of effect. Clin Neuropharmacol 19: 202–212

    Article  PubMed  CAS  Google Scholar 

  • Blanchet PJ, Papa SM, Metman LV, Mouradian MM, Chase TN (1997) Modulation of levodopa-induced motor response complications by NMD A antagonists in Parkinson’s disease. Neurosci Biobehav Rev 21: 447–453

    Article  PubMed  CAS  Google Scholar 

  • Block G, Liss C, Reines S et al. (1997) Comparison of immediate-release and controlled-release carbidopa/levodopa in Parkinson’s disease. A multicenter 5-year study. Eur Neurol 37: 23–27

    Article  PubMed  CAS  Google Scholar 

  • Brannan T, Yahr MD (1995) Comparative study of selegiline plus L-DOPA-carbidopa versus L-DOPA-carbidopa alone in the treatment of Parkinson’s disease. Ann Neurol 37: 95–98

    Article  PubMed  CAS  Google Scholar 

  • Brooks DJ, Torjanski N, Burn DJ (1996) Ropinirole in the symptomatic treatment of Parkinson’s disease. J Neural Transm [Suppl] 45: 231–238

    Google Scholar 

  • Calon F, Goulet M, Blanchet PJ, Martel JC, Piercey MF, Bedard PJ, Di Paolo T (1995) Levodopa or D2 agonist induced dyskinesia in MPTP monkeys: correlation with changes in dopamine and GABAA receptors in the striato-pallidal complex. Brain Res 680: 43–52

    Article  PubMed  CAS  Google Scholar 

  • Carpentier AF, Bonnet AM, Vidailhet M, Agid Y (1996) Improvement of levodopa-induced dyskinesias by propanolol in Parkinson’s disease. Neurology 46: 1548–1551

    Article  PubMed  CAS  Google Scholar 

  • Carter JH, Nutt JG, Woodward WR, Hatcher LF, Trotman TL (1989) Amount and distribution of dietary protein affects clinical response to levodopa in Parkinson’s disease. Neurology 39: 552–556.

    Article  PubMed  CAS  Google Scholar 

  • Dubois B, Danze F, Pillon B et al. (1987) Cholinergic-dependent cognitive deficits in Parkinson’s disease. Ann Neurol 22: 26–30

    Article  PubMed  CAS  Google Scholar 

  • Dupont E, Andersen A, Boas J et al. (1996) Sustained-release Madopar HBS compared with standard Madopar in the long-term treatment of de novo parkinsonian patients. Acta Neurol Scand 93: 14–20

    Article  PubMed  CAS  Google Scholar 

  • Durif F, Vidailhet M, Bonnet AM, Blin J, Agid Y (1995) Levodopa-induced dyskinesias are improved by fluoxetine. Neurology 45: 1855–1858

    Article  PubMed  CAS  Google Scholar 

  • Durif F, Vidailhet M, Assal F et al. (1997) Low-dose clozapine improves dyskinesias in Parkinson’s disease. Neurology 48: 658–662

    Article  PubMed  CAS  Google Scholar 

  • Facca A, Sanchez-Ramos J (1996) High-dose per-golide monotherapy in the treatment of severe levodopa-induced dyskinesias. Mov Disord 11: 327–329

    Article  PubMed  CAS  Google Scholar 

  • Gimenez-Roldan S, Tolosa E, Burguera JA et al. (1997) Early combination of bromocriptine and levodopa in Parkinson’s disease. Clin Neuropharmacol 20: 67–76

    Article  PubMed  CAS  Google Scholar 

  • Giovannini P, Seigliano G, Piccolo I et al. (1988) Lisuride in Parkinson’s disease. Four year follow-up. Clin Neuropharmacol 11: 201–211

    CAS  Google Scholar 

  • Goetz CG, Tanner CM, Shannon KM (1987) Progression of Parkinson’s disease without levodopa. Neurology 37: 695–698

    Article  PubMed  CAS  Google Scholar 

  • Hagan JJ, Middlemiss DN, Sharpe PC, Poste GH (1997) Parkinson’s disease: prospects for improved drug therapy. Trends Pharmacol Sci 18 156–163.

    PubMed  CAS  Google Scholar 

  • Hoehn MM (1985) Results of chronic levodopa therapy and its modification by bromocriptine in Parkinson’s disease. Acta Neurol Scand 71: 97–106

    Article  PubMed  CAS  Google Scholar 

  • Hoehn MM, Yahr DM (1967) Parkinsonism: onset, progression and mortality. Neurology 17: 427–442

    Article  PubMed  CAS  Google Scholar 

  • Hubble JP, Koller WC, Cutler NR et al. (1995) Pramipexole in patients with early Parkinson’s disease. Clin Neuropharmacol 18: 338–347

    Article  PubMed  CAS  Google Scholar 

  • Huttonjt, Morris JL, Brewer MA (1993) Controlled study of the antiparkinsonian activity and tolerability of cabergoline. Neurology 43: 613–616

    Article  Google Scholar 

  • Inzelberg R, Nisipeanu P, Rabey JM et al. (1996) Double-blind comparison of cabergoline and bromocriptine in Parkinson’s disease patients with motor fluctuations. Neurology 47:785–788

    Article  PubMed  CAS  Google Scholar 

  • Kempster PA, Frankel JP, Boringdon M et al. (1989) Levodopa, peripheral pharmacokinetics and duration of motor response in Parkinson’s disease. J Neurol Neurosurg Psychiatry 52: 718–723

    Article  PubMed  CAS  Google Scholar 

  • Korczyn AD, Brooks DJ, Brunt ER, Poewe WH, Rascol O, Stocchi F (1998) Ropinirole versus bromocriptine in the treatment of early Parkinson’s disease, a 6-month interim report of a 3-year study. 053 Study Group. Mov Disord 13: 46–51

    Article  PubMed  CAS  Google Scholar 

  • Larsen JP, Boas J (1997) The effect of early selegiline therapy on long-term levodopa treatment and parkinsonian disability: an interim analysis of a Norwegian-Danish 5-year study. Norwegian-Danish Study Group. Mov Disord 12: 175–182

    Article  PubMed  CAS  Google Scholar 

  • Lees AJ, Stern GM (1983) Sustained low dose levodopa therapy in Parkinson’s disease. A 3-year follow-up. Adv Neurol 37: 9–15

    PubMed  CAS  Google Scholar 

  • Lees AJ (1995) Comparison of therapeutic effects and mortality data of levodopa and levodopa combined with selegiline in patients with early, mild Parkinson’s disease. Parkinson’s Disease Research Group of the United Kingdom. BMJ 311: 1602–1607

    Article  PubMed  CAS  Google Scholar 

  • Lera G, Vaamonde J, Rodriguez M, Obesco JA (1993) Cabergoline in Parkinson’s disease: long-term follow-up. Neurology 43: 2587–2590

    Article  PubMed  CAS  Google Scholar 

  • Le Witt PA, Truong DD (1990) Budipine in Parkinson’s disease. In: Koller WC, Paulson G (eds) Therapy of Parkinson’s disease. Marcel Dekker, New York, pp 399–404

    Google Scholar 

  • Marsden CD, Parkes JD (1976) „On-off“ effects in patients with Parkinson’s disease on chronic levodopa therapy. Lancet i: 292–296

    Article  Google Scholar 

  • Mizuno Y, Kondo T (1997) Mortality associated with selegiline in Parkinson’s disease. What do the available data mean? Drug Saf 16: 289–294

    Article  PubMed  CAS  Google Scholar 

  • Molho ES, Factor SA, Weiner WJ, Sanchez-Ramos JR, Singer C, Shulman L, Brown D, Sheldon C (1995) The use of pramipexole, a novel dopamine (DA) agonist in advanced Parkinson’s disease. J Neural Transm 45: 225–230

    CAS  Google Scholar 

  • Montastruc JL, Rascol O, Senard JM, Rascol A (1994) A randomized controlled study comparing bromocriptine to which levodopa was later added, with levodopa alone in previously untreated patients with Parkinson’s disease: a five year follow up. J Neurol Neurosurg Psychiatry 57: 1034–1038

    Article  PubMed  CAS  Google Scholar 

  • Myllylä W, Woodward WR, Hammerstad JP et al. (1995) Early selegiline therapy reduces levodopa dose requirement in Parkinson’s disease. Acta Neurol Scand 91: 177–182

    Article  PubMed  Google Scholar 

  • Myllylä W, Sotaniemi KA, Hakulinen P, Maki-Ikola O, Heinomen EH (1997) Selegiline as the primary treatment of Parkinson’s disease — a long-term double-blind study. Acta Neurol Scand 95: 211–218

    Article  PubMed  Google Scholar 

  • Nutt JG, Carter JH, Woodward WR (1994) Effect of brief levodopa holidays on the short-duration response to levodopa: evidence for tolerance to the antiparkinsonian effects. Neurology 44: 1617–1622

    Article  PubMed  CAS  Google Scholar 

  • Oertel WH, Quinn NP (1996) Parkinsonism. In: Brandt T et al. (eds) Neurological disorders — course and treatment. Academic Press, San Diego, pp 715–772

    Google Scholar 

  • Oertel WH, Pogarell O, Gasser T, Van Hilten R, Spieker S, Pollentier S, Meier D (1998) Pramipexole in the treatment of tremor-dominant or mixed-type Parkinson’s disease with predominant rest tremor. 5th International Congress of Movement Disorders (submitted)

    Google Scholar 

  • Parkinson’s Disease Research Group in The United Kingdom (1993) Comparisons of therapeutic effects of levodopa, levodopa and selegiline, and bromocriptine in patients with early, mild Parkinson’s disease: three year interim report. Br Med J 307: 469–472

    Article  Google Scholar 

  • Parkinson Study Group (1989) Effect of deprenyl on the progression and disability in early Parkinson’s disease. N Engl J Med 321: 1364–1371

    Article  Google Scholar 

  • Parkinson Study Group (1996a) Impact of deprenyl and tocopherol treatment on Parkinson’s disease in DATATOP subjects not requiring levodopa. Ann Neurol 39: 29–36

    Article  Google Scholar 

  • Parkinson Study Group (1996b) Impact of deprenyl and tocopherol treatment on Parkinson’s disease in DATATOP subjects requiring levodopa. Ann Neurol 39: 37–45

    Article  Google Scholar 

  • Parkinson Study Group (1997) Safety and efficacy of pramipexole in early Parkinson’s disease. A randomized dose-ranging study. JAMA 278: 125–130

    Google Scholar 

  • Pincus JH, Barry KM (1987) Influence of dietary protein on motor fluctuations in Parkinson’s disease. Arch Neurol 44: 270–272

    Article  PubMed  CAS  Google Scholar 

  • Poewe W, Granata R (1997) Pharmacological treatment of Parkinson’s disease. In: Watts RL, Koller WC (eds) Movement disorders — neurological principles and practice. MacGraw-Hill, New York, pp 201–219

    Google Scholar 

  • Poewe W, Lees AJ, Stern GM (1986) Low-dose L-dopa therapy in Parkinson’s disease: a 6-year follow-up study. Neurology 36: 1528–1530

    Article  PubMed  CAS  Google Scholar 

  • Poewe W, Kleedorfer B, Wagner M, Bosch S, Schelosky L (1993) Continuous subcutaneous apomorphine infusions for fluctuating Parkinson’s disease. Long-term follow-up in 18 patients. Adv Neurol 60: 656–659

    PubMed  CAS  Google Scholar 

  • Przuntek H, Welzel D, Blümner E, Danielczyk W, Letzel H, Kaiser H-J, Kraus PH, Riederer P, Schwarzmann D, Wolf H, überla K (1992) Bromocriptine lessens the incidence of mortality in L-Dopa-treated parkinsonian patients: Prado-study discontinued. Eur J Clin Pharmacol 43: 357–363

    Article  PubMed  CAS  Google Scholar 

  • Przuntek H, Welzel D, Gerlach M, Blümner E, Danielczy KW, Kaiser H-J, Letze LH, Riedere RP, überla K (1996) Early institution of bromocriptine in Parkinsons’s disease inhibits the emergence of levodopa-associated motor side effects. Long-term results of the PRADO study. J Neural Transm 103: 699–715

    CAS  Google Scholar 

  • Quinn NP, Critchley P, Marsden CD (1987) Young onset Parkinson’s disease. Mov Disord 1: 209–219

    Google Scholar 

  • Rabey JM, Nissipeanu P, Inzelberg R, Korczyn AD (1994) Beneficial effect of cabergoline, a new long-lasting D2 agonist, in the treatment of Parkinson’s disease. Clin Neuropharmacol 17: 286–293

    Article  PubMed  CAS  Google Scholar 

  • Rajput AH, Stern W, Laverty WH (1984) Chronic low-dose levodopa therapy in Parkinson’s disease: an argument for delaying levodopa therapy. Neurology 34: 991–996

    Article  PubMed  CAS  Google Scholar 

  • Rajput AH, Urrn RJ, Lang AE et al. (1997) Amantadine ameliorates levodopa-induced dyskinesias. Neurology 48 (S2): A328

    Google Scholar 

  • Rascol O (1994) Anti-Parkinson efficacy of ropinirole vs placebo as early therapy in Parkinson’s disease: 11th International Symposium on Parkinson’s Disease, Rome. New Trends Clin Neuropharmacol 8: 279

    Google Scholar 

  • Rascol O, Lees AJ, Senard JM, Pirtosek Z, Brefel C, Montastruc JL, Fuell D (1996) A placebo-controlled study of ropinirole, a new D2 agonist, in the treatment of motor fluctuations of L-DOPA-treated parkinsonian patients. Adv Neurol 69: 531–534

    PubMed  CAS  Google Scholar 

  • Rascol O, Brooks DJ, Brunt ER, Korczyn AD, Poewe WH, Stocchi F (1998) Ropinirole in the treatment of early Parkinson’s disease: a 6-month interim report of a 5-year levodopa-controlled study. 056 Study Group. Mov Disord 13: 39–45

    Article  PubMed  CAS  Google Scholar 

  • Riley D, Lang AE (1988) Practical application of a low-protein diet for Parkinson’s disease. Neurology 38: 1026–1031

    Article  PubMed  CAS  Google Scholar 

  • Rinne UK (1985) Combined bromocriptine-levo-dopa therapy early in Parkinson’s disease. Neurology 35: 1196–1198

    Article  PubMed  CAS  Google Scholar 

  • Rinne UK (1986) Dopamine agonists as primary treatment in Parkinson’s disease. Adv Neurol 45: 519–523

    Google Scholar 

  • Rinne UK (1989) Lisuride, a dopamine agonist in the treatment of early Parkinson’s disease. Neurology 39: 336–339

    Article  PubMed  CAS  Google Scholar 

  • Rinne UK, Bracco F, Chouza C et al. (1998) Early treatment of Parkinson’s disease with cabergoline delays the onset of motor complications: results of a double-blind, levodopa controlled trial. The PKDS009 Study Group. Drugs 55 (S1): 23–30

    Article  PubMed  CAS  Google Scholar 

  • Röhl A, Friedrich HJ, Ulm G, Vieregge P (1994) The relevance of clinical subtypes for disease course, family history and epidemiological variables in Parkinson’s disease. Eur J Neurol 1: 65–72

    Article  Google Scholar 

  • Roos RAC, Jangen JCF, Van Der Velde EA (1996) Clinical course of patients with idiopathic Parkinson’s disease. Mov Disord 11: 236–242

    Article  PubMed  CAS  Google Scholar 

  • Sadeh M, Braham J, Modan M (1982) Effects of anticholinergic drugs on memory in Parkinson’s disease. Arch Neurol 39: 666–667

    Article  PubMed  CAS  Google Scholar 

  • Shannon KM (1997) Pramipexole monotherapy in early Parkinson’s disease: long-term follow-up and interim analysis. XIIth International Symposium on Parkinson’s Disease, London, March 23–26, 1997

    Google Scholar 

  • Spieker S, Löschmann PA, Jentgens C, Boose A, Klockgethe RT, Dichgans J (1995) Tremorlytic activity of budipine: a quantitative study with long-term tremor recordings. Clin Neuropharmacol 18: 266–272

    Article  PubMed  CAS  Google Scholar 

  • Steiger MJ, Stocchi F, Bramante L et al. (1992) The clinical efficacy of single morning doses of levodopa methylester, dispersible madopar and sinemet plus in Parkinson’s disease. Clin Neuropharmacol 15: 501–504

    Article  PubMed  CAS  Google Scholar 

  • Turkka J, Suominen K, Tolonen U, Sotaniemi K, Myllyla W (1997) Selegiline diminishes cardiovascular autonomic responses in Parkinson’s disease. Neurology 48: 662–667

    Article  PubMed  CAS  Google Scholar 

  • Verhagen-Metman L, Del Dotto P, Van Den Munckhof BS, Fang J, Mouradian MM, Chase TN (1998) Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson’s disease. Neurology 50: 1323–1326

    Article  PubMed  CAS  Google Scholar 

  • Weiner WJ, Factor SA, Sanchez-Ramos RJ et al. (1993) Early combination therapy (bromocriptine and levodopa) does not prevent motor fluctuations in Parkinson’s disease. Neurology 43: 21–27

    Article  PubMed  CAS  Google Scholar 

  • Wermuth L, Boas J, Gyring J et al. (1994) Prami-pexol — a new dopamine agonist for treatment of Parkinson’s disease: 11th International Symposium on Parkinson’s Disease, Rome. New Trends Clin Neuropharmacol 8: 280

    Google Scholar 

  • Wolters EC, Tissingh G, Bergmans PLM, Kuiper MA (1995) Dopamine agonists in Parkinson’s disease. Neurology 45 (S3): S28–S34

    Article  PubMed  CAS  Google Scholar 

  • Wolters EC, Tesselaar HJ (1996) International (NL-UK) double-blind study of sinemet CR and standard sinemet (25/100) in 170 patients with fluctuating Parkinson’s disease. J Neurol 243: 235–240

    Article  PubMed  CAS  Google Scholar 

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Oertel, W. (1999). Therapieempfehlungen der Früh- und Spätphase der Parkinson-Krankheit. In: Riederer, P., Laux, G., Pöldinger, W. (eds) Neuro-Psychopharmaka Ein Therapie-Handbuch. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6400-6_35

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