Galli_cimolin_vimercati_albertini_onorati_depandis_506_1475_24135_2479_2480_2481_2482_final

QUANTIFICATION OF EFFECTS OF LEVODOPA
TREATMENT IN PARKINSONIAN SYNDROMES
GALLI, M., CIMOLIN, V., VIMERCATI S., ALBERTINI, G., ONORATI,
Abstract: The purpose of this chapter is to present the experience of the Posture and
Motion Laboratory at the “San Raffaele Cassino” in the field of use of Gait
Analysis (GA) in patients with Parkinson’s disease (PD) and with Progressive
Supranuclear Palsy (PSP). In particular, the effects of levodopa medication on PD
vs. PSP patients were quantified, comparing the OFF and ON state in the two
different pathological conditions, using functional evaluation and GA. Data of the
OFF and ON states in 10 PSP patients and 11 PD patients were compared. The
results highlighted that the treatment based on Levodopa treatment had significant
effects only on PD group (spatio-temporal parameters, kinematics and kinetics); PSP
patients revealed no significant changes after the levodopa therapy.
Key words: Parkinson’s disease, PSP, Gait Analysis

Authors´ data: Eng. Galli M[anuela]*, **; Eng. Cimolin V[eronica]*, Eng.
Vimercati S[ara]*Prof. Albertini G[iorgio]**, Dr. Onorati P[aolo]***, Dr. De
Pandis M[aria] F[rancesca]***, *Bioeng. Dept., Politecnico di Milano, Milano, Italy,
** IRCCS “San Raffaele Pisana” Tosinvest Sanità, Roma, Italy; ***“San Raffaele
Cassino” Institute, Tosinvest Sanità, Cassino, Italy
[email protected];[email protected];[email protected];giorgi
[email protected]; [email protected];
[email protected]
This Publication has to be referred as: Galli M[anuela], Cimolin V[eronica],
Albertini G[iorgio], Onorati P[aolo], De Pandis M[aria] F[rancesca] (2010).
Quantification of effects of Levodopa treatment in Parkinsonian syndromes, Chapter
xx in DAAAM International Scientific Book 2010, pp. xxx-xxx, B. Katalinic (Ed.),
Published by DAAAM International, ISBN 978-3-901509-71-1, ISSN 1726-9687,
Vienna,

3. Conclusions
The experience of the Posture and Motion Laboratory at the “San Raffaele Cassino”
is described in the field of the use of GA in patients with PD and PSP. Our results
demonstrated that quantitative GA may represent a precise, objective and reliable
alternative to rating scales and commonly used tests in determining the dopaminergic
response in patients with PD and PSP which provides a systematic evaluation to help
in the early differentiation of PSP from other parkinsonian syndromes, like PD.
Further studies should be conducted on this direction, with larger group of patients
and considering sub-groups of patients, evaluating for example PD patients with
walking problems or with freezing, in order to evaluate quantitatively if different
responses to levodopa are found.

4. References
Davis R B, Ounpuu S, Tyburski D J, Gage JR. A gait analysis data collection and
reduction technique. Human Movement Science 1991; 10: 575-587
Fahn S, Elton R, Members of the UPDRS Development Committee. In: Fahn S,
Marsden CD, Calne DB, Goldstein M, eds. Recent Developments in Parkinson's
Disease, Vol 2. Florham Park, NJ. Macmillan Health Care Information 1987, pp 15
3-163, 293-304
Gage J.R. The treatment of gait problems in cerebral palsy. Gage JR editor. London:
Cambridge University Press; 2004
Golbe LI, Ohman-Strickland P. A clinical tasting scale for progressive supranuclear
palsy. Brain 2007; 130: 1552-1565
Holmberg B, Johnels B, Ingvarsson P, Eriksson B, Resengren L. CSF-neurofilament
and levodopa tests combined with discriminant analysis may contribute to the
differential diagnosis of Parkinsonian syndromes. Parkinsonism and Related
Disorders 2001; 8: 23-31
Keith RA, Granger CV, Hamilton BB, Sherwin FS. The Functional Independence
Measure: a new tool for rehabilitation. In: Advances in clinical rehabilitation—
Eisenberg MG, Grzesiak RC, eds. (1987) New York: Springer. 6–18
Lubik S, Fogel W, Tronnier V, Krause M, Konig J, Jost WH. Gait analysis in patients
with advanced Parkinson disease: different or additive effects on gait induced by
levodopa and chronic STN stimulation. Journal of Neural Transmission 2006; 113:
163-173
Moore ST, MacDougall HG, Gracies JM, Cohen HS, Ondo WG. Locomotor response
to levodopa in fluctuating Parkinson’s disease. Exp Brain Res 2008; 184: 469-478
Morris ME, Huxham F, McGinley J, Dodd K, Iansek R. The biomechanics and motor
control of gait in Parkinson disease. Clinical Biomechanics 2001; 16: 459-470
Vokaer M, Abou Azar N, Zegers de Bayl D. Effects of levodopa on upper limb
mobility and gait in Parkinson’s disease. Journal of Neurology, Neurosurgery and
Psychiatry 2003; 74: 1304-1307.

Source: http://analisedemarcha.com/papers/pkd/QUANTIFICATION%20OF%20EFFECTS%20OF%20LEVODOPA.pdf