Objective: To define the role of long-duration response (LDR) in motor learning, evaluating neurophysiological parameters in patients affected by Parkinson’s disease (PD) with and without LDR and undergone or not motor learning skills.

Background: LDR derived from prolonged administration of levodopa in PD [1]. Animal models supported the hypothesis that LDR is implicated in motor learning [2]. P300, motor evoked potentials (MEPs) and Bereitschaftspotential (BP) are neurophysiological tools to quantify motor learning in humans.

Method: Drug-naive PD patients were prospectively enrolled. Patients underwent a 15-day-treatment of levodopa/carbidopa 250/25 mg at 24 h interdose intervals and randomized to perform or not a 15-day motor-training skill. Achievement of LDR was assessed at 15th day of treatment. Patients underwent clinical (Unified Parkinson’s Disease Rating Scale motor section and Hoehn and Yahr stage) and neurophysiological (P300, MEPs and BP) assessments at baseline (T0) and at 15th day of treatment, before taking levodopa (T15).

Results: Thirty PD patients were enrolled: 9 trained patients with a sustained LDR (Group 1), 8 untrained patients with a sustained LDR (Group 2), 7 trained patients without a stable LDR (Group 3) and 6 untrained patients without a stable LDR (Group 4). A statistically significant improvement of P300 latency, MEPs amplitude and early and late BP latencies was observed in Group 1 from T0 to T15 (p<0.006; p<0.03; p<0.02; p<0.002). A statistically significant improvement of early and late BP latencies was observed in Group 2 from T0 to T15 (p<0.001; p<0.005). No significant differences of neurophysiological parameters were found in Group 3 and 4 from T0 to T15.

Conclusion: Our findings support the hypothesis that LDR promote motor learning in PD patients.

References: References 1. Zappia M, Oliveri RL, Montesanti R, Rizzo M, Bosco D, Plastino M, Crescibene L, Bastone L, Aguglia U, Gambardella A, Quattrone A. Loss of long-duration response to levodopa over time in PD: implications for wearing-off. Neurology 1999; 52 (4): 763-767. 2. Beeler JA, Cao ZF, Kheirbek MA, Ding Y, Koranda J, Murakami M, Kang UJ, Zhuang X. Dopamine-dependent motor learning: insight into levodopa’s long-duration response. Ann Neurol 2010; 67(5): 639-647.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-learning-and-long-duration-response-to-levodopa-in-parkinsons-disease/