Effect of low concentrations of apomorphine on parkinsonism in a randomized, placebo-controlled, crossover study

Steven A. Gunzler, Caroline Koudelka, Nichole E. Carlson, Misha Pavel, John G. Nutt

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective: To determine whether low concentrations of a dopamine agonist worsen parkinsonism, which would suggest that activation of presynaptic dopamine autoreceptors causes a super-off state. Design: Randomized, double-blind, placebo-controlled, crossover clinical trial. Setting: Academic movement disorders center. Patients: Patients with Parkinson disease and motor fluctuations. Intervention: Fourteen patients with Parkinson disease and motor fluctuations were randomized to receive 1 of 6 possible sequences of placebo, low-dose (sub-threshold) apomorphine hydrochloride, and high-dose (threshold to suprathreshold) apomorphine hydrochloride infusions. Subthreshold doses of apomorphine hydrochloride (12.5 μg/kg/h every 2 hours and 25 μg/kg/h every 2 hours), threshold to suprathreshold doses of apomorphine hydrochloride (50 μg/kg/h every 2 hours and 100 μg/kg/h every 2 hours), and placebo were infused for 4 hours daily for 3 consecutive days. Main Outcome Measures: Finger and foot tapping rates. Results: There was no decline in finger or foot tapping rates during the low-dose apomorphine hydrochloride infusions relative to placebo. The high-dose infusions increased foot tapping (P<.001) and trended toward increasing finger tapping compared with placebo infusions. Conclusions: Subthreshold concentrations of apomorphine did not worsen parkinsonism, suggesting that presynaptic dopamine autoreceptors are not important to the motor response in moderate to advanced Parkinson disease.

Original languageEnglish (US)
Pages (from-to)193-198
Number of pages6
JournalArchives of Neurology
Volume65
Issue number2
DOIs
StatePublished - Feb 2008

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Effect of low concentrations of apomorphine on parkinsonism in a randomized, placebo-controlled, crossover study'. Together they form a unique fingerprint.

Cite this