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Impact of Levodopa in Lung Functions in Patients with Parkinson Disease.
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2020-05-01 , DOI: 10.4103/aian.aian_88_19 Medha Tandon 1, 2, 3 , Faiz M H Ahmad 1, 2, 3 , Subramanian Narayanan 1, 2, 3 , Charu Mohan 1, 2, 3 , Simone Yadav 1, 2, 3
Background: Parkinson's disease (PD) is the second-most common neurodegenerative disorder known primarily by its motor symptomatology. These motor manifestations are also hypothesised to affect the respiratory muscular function of PD patients contributing to restrictive pattern of ventilatory dysfunction. Previous reports attempting to detect these abnormalities through spirometric assessments have been inconclusive. Attempts at reversal of the restrictive abnormalities by levodopa therapy too, have yielded conflicting results. Objectives: This study aims to classify spirometric abnormalities in asymptomatic PD patients after levopopa withdrawal and document changes after levodopa replacement. Methods: Thirty-six non-smoker PD patients without pre-existing respiratory abnormalities were enrolled. Their standard spirometric values- FEV1, FVC and FEV1/FVC, were noted before and after their morning levodopa dose. Results: Nineteen patients had abnormal PFT values at baseline - 14 restrictive and 5 obstructive defects. Fourteen patients showed improvement in their pulmonary performances after dopamine administration with 6 showing complete reversibility. Statistically significant improvement in the post-levodopa FVC values was seen in patients with restrictive disorder (P value=0.04) but not for obstructive disorders. Discussions: This pilot study characterised that 39% of PD patients had restrictive ventilatory defects prior to morning dopamine administration. Of these, 40% showed improvement after levodopa administration. Conclusion: Restrictive defects are common in PD patients which are evident on routine spirometric screening. These defects are reversible on levodopa administration.
中文翻译：
左旋多巴对帕金森病患者肺功能的影响。
背景：帕金森病（PD）是第二常见的神经退行性疾病，主要因其运动症状而闻名。这些运动表现也被认为会影响帕金森病患者的呼吸肌肉功能，从而导致通气功能障碍的限制性模式。之前的报告试图通过肺量测定评估来检测这些异常，但尚未得出结论。通过左旋多巴疗法逆转限制性异常的尝试也产生了相互矛盾的结果。目的：本研究旨在对左旋多巴停药后无症状 PD 患者的肺量异常进行分类，并记录左旋多巴替代后的变化。方法：纳入 36 名既往无呼吸系统异常的非吸烟 PD 患者。他们在早晨服用左旋多巴之前和之后记录了他们的标准肺量测定值 - FEV1、FVC 和 FEV1/FVC。结果： 19 名患者在基线时 PFT 值异常 - 14 名限制性缺陷和 5 名阻塞性缺陷。给予多巴胺后，14 名患者的肺部表现有所改善，其中 6 名患者表现出完全可逆性。限制性障碍患者使用左旋多巴后 FVC 值有统计学意义的显着改善（ P值 = 0.04），但阻塞性障碍患者则没有这种改善。讨论：这项试点研究的特点是，39% 的 PD 患者在早晨服用多巴胺之前存在限制性通气缺陷。其中，40% 在服用左旋多巴后表现出改善。结论：限制性缺陷在 PD 患者中很常见，这在常规肺量计筛查中很明显。 这些缺陷在服用左旋多巴后是可逆的。
更新日期：2020-05-01
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2020-05-01 , DOI: 10.4103/aian.aian_88_19 Medha Tandon 1, 2, 3 , Faiz M H Ahmad 1, 2, 3 , Subramanian Narayanan 1, 2, 3 , Charu Mohan 1, 2, 3 , Simone Yadav 1, 2, 3
Affiliation
Background: Parkinson's disease (PD) is the second-most common neurodegenerative disorder known primarily by its motor symptomatology. These motor manifestations are also hypothesised to affect the respiratory muscular function of PD patients contributing to restrictive pattern of ventilatory dysfunction. Previous reports attempting to detect these abnormalities through spirometric assessments have been inconclusive. Attempts at reversal of the restrictive abnormalities by levodopa therapy too, have yielded conflicting results. Objectives: This study aims to classify spirometric abnormalities in asymptomatic PD patients after levopopa withdrawal and document changes after levodopa replacement. Methods: Thirty-six non-smoker PD patients without pre-existing respiratory abnormalities were enrolled. Their standard spirometric values- FEV1, FVC and FEV1/FVC, were noted before and after their morning levodopa dose. Results: Nineteen patients had abnormal PFT values at baseline - 14 restrictive and 5 obstructive defects. Fourteen patients showed improvement in their pulmonary performances after dopamine administration with 6 showing complete reversibility. Statistically significant improvement in the post-levodopa FVC values was seen in patients with restrictive disorder (P value=0.04) but not for obstructive disorders. Discussions: This pilot study characterised that 39% of PD patients had restrictive ventilatory defects prior to morning dopamine administration. Of these, 40% showed improvement after levodopa administration. Conclusion: Restrictive defects are common in PD patients which are evident on routine spirometric screening. These defects are reversible on levodopa administration.
中文翻译：
左旋多巴对帕金森病患者肺功能的影响。
背景：帕金森病（PD）是第二常见的神经退行性疾病，主要因其运动症状而闻名。这些运动表现也被认为会影响帕金森病患者的呼吸肌肉功能，从而导致通气功能障碍的限制性模式。之前的报告试图通过肺量测定评估来检测这些异常，但尚未得出结论。通过左旋多巴疗法逆转限制性异常的尝试也产生了相互矛盾的结果。目的：本研究旨在对左旋多巴停药后无症状 PD 患者的肺量异常进行分类，并记录左旋多巴替代后的变化。方法：纳入 36 名既往无呼吸系统异常的非吸烟 PD 患者。他们在早晨服用左旋多巴之前和之后记录了他们的标准肺量测定值 - FEV1、FVC 和 FEV1/FVC。结果： 19 名患者在基线时 PFT 值异常 - 14 名限制性缺陷和 5 名阻塞性缺陷。给予多巴胺后，14 名患者的肺部表现有所改善，其中 6 名患者表现出完全可逆性。限制性障碍患者使用左旋多巴后 FVC 值有统计学意义的显着改善（ P值 = 0.04），但阻塞性障碍患者则没有这种改善。讨论：这项试点研究的特点是，39% 的 PD 患者在早晨服用多巴胺之前存在限制性通气缺陷。其中，40% 在服用左旋多巴后表现出改善。结论：限制性缺陷在 PD 患者中很常见，这在常规肺量计筛查中很明显。 这些缺陷在服用左旋多巴后是可逆的。
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