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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Tapping and peg insertion after levodopa intake in treated and de novo parkinsonian patients.
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Tapping and peg insertion after levodopa intake in treated and de novo parkinsonian patients.

机译：接受左旋多巴治疗的帕金森病患者和从头开始的帕金森病患者的攻牙和栓钉插入术。

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BACKGROUND: Investigators use instrumental tasks for objective assessment of parkinsonian motor disability and its drug response. To date, such studies on treated parkinsonian patients have not addressed acute and long-term effects of dopaminergic drugs. OBJECTIVES: To determine the impact of long-term dopaminergic therapy within a standardized levodopa challenge test design in combination with two repeatedly performed instrumental tasks, peg insertion and tapping, in previously treated and untreated parkinsonian patients. RESULTS: Tapping significantly deteriorated in previously untreated, but not in treated parkinsonian patients after levodopa intake. In contrast, motor symptoms and peg insertion significantly improved in both groups of parkinsonian patients. Results of both tests differed between parkinsonian patients and matched controls. CONCLUSION: Worsening of cognitively less demanding tapping may result from upregulated presynaptic inhibitory feedback regulation, sedative effects of levodopa or dopamine overflow in untreated parkinsonian patients, who are sensitive to these effects in contrast to treated parkinsonian patients. Tapping is a task with autonomic repetitive performance and programming of standardised movements with a low need for cognitive effort. This autonomic functioning of attentional control and selective processing is intact in Parkinson's disease. Peg insertion depends on more complex movements and thus hypothetically on dopamine-associated cognitive processes. Therefore, impairment of peg insertion responded to dopaminergic stimulation in both groups of parkinsonian patients. Future studies on the efficacy of antiparkinsonian drugs, using instrumental tasks for objective assessment, should consider long-term impact of antiparkinsonian drug therapy and associated cognitive efforts.
机译：背景：研究人员使用工具性任务来客观评估帕金森氏运动障碍及其药物反应。迄今为止，对已治疗的帕金森氏病患者的此类研究尚未解决多巴胺能药物的急性和长期作用。目的：确定长期多巴胺能疗法在标准化左旋多巴激发试验设计中结合两个重复执行的器械任务（插钉和敲打）对先前治疗和未治疗的帕金森病患者的影响。结果：以前未经治疗的帕金森病患者在服用左旋多巴后，其轻拍明显恶化，但未经治疗的帕金森病患者却没有。相比之下，两组帕金森病患者的运动症状和钉插入明显改善。帕金森氏病患者和匹配的对照组之间的两种测试结果均不同。结论：突触前抑制性反馈调节上调，左旋多巴或多巴胺溢流在未接受治疗的帕金森病患者中的镇静作用可能导致认知要求降低的敲击加重，与接受治疗的帕金森病患者相比，后者对这些作用敏感。敲击是一项具有自主重复性功能的任务，并且对标准化动作进行了编程，而对认知力的需求很少。注意控制和选择性处理的这种自主功能在帕金森氏病中是完整的。钉的插入取决于更复杂的运动，因此假想取决于多巴胺相关的认知过程。因此，两组帕金森病患者的桩钉插入障碍均对多巴胺能刺激产生反应。使用工具性任务进行客观评估的抗帕金森病药物疗效的未来研究应考虑抗帕金森病药物治疗的长期影响以及相关的认知努力。

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