Objective: To evaluate the natural progression of Parkinson disease (PD) in patients on less pulsatile levodopa therapy (LPT).
Background: Previously we have shown that patients with Parkinson disease on LPT experienced a reduced incidence of levodopa-induced dyskinesia (LID)[1]. However, the natural progression and the incidence of freezing in LPT treated patients with early Parkinson disease has not been studied.
Method: This is a retrospective cohort study of patients with Parkinson disease at the movement disorders clinic of Medstar Washington Hospital Center. Patients with early Parkinson disease were seen between February 2018 and February 2022. During these years, we started or continued to treat patients with less pulsatile (6 doses daily) levodopa therapy. We recorded the occurrence of LID, freezing episodes, the Hoehn & Yahr stage and the UPDRS-III during the study period for patients without significant exposure to traditional pulsatile levodopa therapy.
Results: Thirty-three patients with early Parkinson disease at the first visit who were compliant with levodopa 6 times per day were found [Table1]. The duration of LPT ranged from 5 months to 10.6 years with mean duration of 5.4 years. There are a few interesting findings in these patients on LPT: 1) there was no LID during the study period. 2) there was no significant freezing except for one patient (on LPT for 10.6 years) who reported occasional freezing prior to the first daily dose of levodopa. 3). Mean Hoehn & Yahr stage was 2.0 at the first visit and 2.0 at the last visit. In no patient was there a significant change of Hoehn & Yahr stage during this period except in one patient who changed from late stage III to early stage IV. 4) Most of the patients with LPT were under optimal treatment with mean UPDRS-III 12.6 [Figure1].
Conclusion: Patients with Parkinson disease on LPT have a low incidence of LID and freezing episodes. They have a stable clinical course. Further study of this method of treatment is warranted.
References: [1] Lin, M.M., Laureno, R., (2019) Less pulsatile levodopa therapy (6 doses daily) is associated with a reduced incidence of dyskinesia. J Mov Disord. 12(1): 37-42. PMID: 30732431 PMCID: PMC6369375 DOI: 10.14802/jmd.18046
To cite this abstract in AMA style:
M. Lin, R. Laureno, A. Lenka. Natural progression of patients with Parkinson disease on less pulsatile levodopa therapy [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/natural-progression-of-patients-with-parkinson-disease-on-less-pulsatile-levodopa-therapy/. Accessed June 14, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/natural-progression-of-patients-with-parkinson-disease-on-less-pulsatile-levodopa-therapy/