Reduction of Parkinsonian signs in patients with Parkinson's disease by dopaminergic versus anticholinergic single-dose challenges.

We investigated the effect of an anticholinergic (biperiden) and a dopamine agonist (apomorphine) on tremor, rigidity, and akinesia in patients with idiopathic Parkinson's disease. In a standardized, crossover study design 17 patients received single-dose challenges of 5 mg biperiden intravenously and a previously determined dose of apomorphine subcutaneously on 2 consecutive days. Resting (RT), postural (PT), and action tremor (AT) were assessed using spectral analysis of accelerometer data, and Unified Parkinson's Disease Rating Scale (UPDRS) scores for rigidity and akinesia were determined before and after administration of the study drug. Both single-dose challenges significantly reduced the amplitude of RT, PT, and AT, but only apomorphine significantly reduced UPDRS scores for rigidity and akinesia. In only one patient was tremor reduced by the dopamine agonist but not by the anticholinergic. We found that anticholinergic and dopaminergic agents are both effective in reducing tremor in IPD, and there was no evidence for a selective anticholinergic responsiveness of parkinsonian tremor. Akinesia and rigidity, on the other hand, were not improved by biperiden. We therefore conclude that dopaminergic substances are as effective as anticholinergics in patients with parkinsonian tremor and additionally improve other parkinsonian signs.
AuthorsA Schrag, L Schelosky, U Scholz, W Poewe
JournalMovement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 14 Issue 2 Pg. 252-5 (Mar 1999) ISSN: 0885-3185 [Print] UNITED STATES
PMID10091618 (Publication Type: Clinical Trial, Comparative Study, Journal Article)
Chemical References
  • Antiparkinson Agents
  • Cholinergic Antagonists
  • Dopamine Agonists
  • Biperiden
  • Apomorphine
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents (pharmacology)
  • Apomorphine (pharmacology)
  • Biperiden (pharmacology)
  • Cholinergic Antagonists (pharmacology)
  • Cross-Over Studies
  • Dopamine Agonists (pharmacology)
  • Female
  • Humans
  • Hypokinesia (drug therapy)
  • Male
  • Middle Aged
  • Muscle Rigidity (drug therapy)
  • Parkinson Disease (drug therapy)
  • Single-Blind Method
  • Tremor (drug therapy)

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