1. A double-blind study of the efficacy of apomorphine and its assessment in 'off-periods in Parkinson's disease
- Author
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R. A. C. Roos, E. N. H. Jansen, A. W. G. Essink, S. Oosterloo, T. van Laar, C. Neef, and Faculty of Behavioural, Management and Social Sciences
- Subjects
Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,Apomorphine ,Injections, Subcutaneous ,Dopamine agonist ,Levodopa ,Central nervous system disease ,Double blind study ,Double-Blind Method ,Rating scale ,Humans ,Medicine ,Adverse effect ,Aged ,Neurologic Examination ,IR-57410 ,business.industry ,Parkinson Disease ,General Medicine ,Middle Aged ,medicine.disease ,Domperidone ,Motor Skills ,Anesthesia ,Physical therapy ,Female ,Surgery ,Neurology (clinical) ,business ,medicine.drug - Abstract
Five patients with idiopathic Parkinson's disease with severe response fluctuations were selected for a randomized double-blind placebo-controlled study, concerning the clinical effects of subcutaneous apomorphine and its assessment in `off¿-periods. The study was designed as five n = 1 studies, in which every patient was his own control. The effect of apomorphine was studied by using the Columbia rating scale and quantitative assessments, using tapping, walking and pinboard. There was a significant positive effect of apomorphine, in a mean optimal dose of 2.7 mg, with a mean latency of onset of 7.3 min and a mean duration of response of 96 min. After pretreatment with domperidone, no significant adverse effects were observed. Tapping showed the highest correlation with rigidity and bradykinesia. Walking showed a high correlation with stability and gait. Pinboard testing did not give additional information. The first conclusion was that apomorphine proved to be a significantly effective dopamine agonist, proven now also by a double blind placebo-controlled study. Secondly it was concluded that assessment of clinical effect in parkinsonian patients can be performed best by combining the Columbia item tremor with tapping and walking scores.
- Published
- 1993
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