期刊
JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY
卷 14, 期 5, 页码 832-841出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1355617708081010
关键词
cognition; dopamine; frontal lobe; basal ganglia; neuropsychology; neuropsychological tests
资金
- Fondo de Investigaciones Sanitarias [PI051916]
- Centro de Investigaciones Biomedicas en Red-Enfermedades Neurodegenerativas (CIBERNED)
Parkinson's disease (PD) patients may experience fluctuations in executive performance after oral levodopa (LD). Their relationship with the pharmacokinetic profile of LD and with distinct cognitive processes associated with frontal-basal ganglia circuits is not well understood. In this randomized, double-blind, crossover study we plotted acute cognitive changes in 14 PD patients challenged with faster (immediate-release, IR) versus slower (controlled-release, CR) increases in LD plasma concentrations. We monitored motor status, LD plasma levels, and performance on four tasks of executive function (Wisconsin Card Sorting Test-WCST, Sternberg test, Stroop and Tower of Hanoi), 1 hr before and over + 6 hr after IR and CR-LD dose. Analysis of variance demonstrated significant but divergent changes in the Sternberg (6-digit but not 2- and 4-digit) test: improvement after CR-LD and worsening after IR-LD. Marginal improvement (p = .085) was observed with CR-LD in the WCST. while no significant differences were seen for the Stroop or Tower of Hanoi tests. Executive-related performance after LD challenge may differ depending on the LD tirne-to-peak plasma concentration and specific task demands. A slower rise in LD levels appears to have a more favorable impact on more difficult working memory tests. These results require replication to determine their generalization.
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