IL TEST ALL'APOMORFINA SOTTOCUTANEO E SUBLINGUALE NEL MORBO DI PARKINSON

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  • P. Piccini, University of Pisa
  • ,
  • P. Del Dotto, University of Pisa
  • ,
  • A. Bertolucci, University of Pisa
  • ,
  • S. Bartolini, University of Pisa
  • ,
  • P. D'Antonio, University of Pisa
  • ,
  • N. Pavese
  • U. Bonuccelli, University of Pisa

The clinical diagnosis of Idiopathic Parkinson's Disease (IPD) remains difficult and is supported by a favourable response to levodopa, while failure to respond represents an exclusion criterion. In recent years subcutaneous (s.c.) apomorphine has come to be used as a tool in predicting levodopa responsiveness in parkinsonian syndromes. We administered apomorphine s.c. at dose of 10, 50 and 100 μg/kg against placebo, over two consecutive days, in 105 patients with parkinsonian features and evaluated motor parameters till to return to basal values. Subsequently, we compared the response to this test with the follow up response to levodopa therapy. 76 patients out of 105 showed a positive response to the apomorphine test and 29 had a negative one. After a 6 month follow up with levodopa/carbidopa therapy 82 patients improved, thus the apomorphine test was 87% predictive of the long-term response to levodopa. Recently, a sublingual (s.l.) formulation of apomorphine has been reported to reduce extrapyramidal symptoms after acute administration. We compared the motor response to apomorphine after 50 μg/kg s.c. and 25 mg s.l. administration. The onset of action of s.l. formulation was delayed with respect to s.c. one. The magnitude of the motor response to both routes was similar, but the apomorphine side effects were less frequent and severe after s.l. administration. These data allow us to affirm that the administration of both s.c. and s.l. formulations of apomorphine are useful as testes of dopaminergic responsiveness in parkinsonian syndromes.

Original languageItalian
JournalRivista di Neurobiologia
Volume38
Issue6
Pages (from-to)527-533
Number of pages7
ISSN0035-6336
Publication statusPublished - 1 Dec 1992
Externally publishedYes

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