Comparative Cognitive Effects of Levo-Dopa Plus Carbidopa and Dopamine Agonist as an Initial Therapy of Parkinson's Disease

J Korean Neurol Assoc > Volume 26(4); 2008 > Article

Journal of the Korean Neurological Association 2008;26(4): 341-346.

파킨슨병 환자의 초기 치료로서 레보도파와 도파민 작용제가 인지기능에 미치는 효과

박재한, 권오대 최소영 이동국

대구가톨릭대학교 의과대학 신경과학교실

Comparative Cognitive Effects of Levo-Dopa Plus Carbidopa and Dopamine Agonist as an Initial Therapy of Parkinson's Disease

Jae Han Park

Department of Neurology, School of Medicine, Catholic University of Daegu, Daegu, Korea

Abstract

Background: Cognitive impairments are common in patients with Parkinson's disease (PD). However little is known about the cognitive effects of dopaminergic therapy.
Methods: The study was a single-blind prospective study of 21 patients with PD. Each patient had received either levodopa (Sinemet?, n=8) or dopamine agonist (Requip?, n=13) during 24 consecutive weeks. Neuropsychological battery, including Korean version of Alzheimer’s Disease Assessment Scale ? cognitive subscale (ADAS-Cog) and frontal-executive function part of SNSB (Seoul Neuropsychological Screening Battery), were performed two times, before and after the 24 weeks of management. Patients also received quantitative ratings of motor symptom severity and functional status using Unified Parkinson's Disease Rating Scale (UPDRS) before and after the dopaminergic therapy.
Results: After six months of treatment, motor scale improved in both groups (p<0.05) without difference between the groups (p>0.05). In ADAS-Cog testing, Requip? group improved at more categories than Sinemet? group but without statistical difference (p>0.05). The results of frontal-executive function test did not differ between the groups, either.
Conclusions: Our study does not provide an evidence that dopaminergic treatment improves cognitive functions in Parkinson’s disease. Furthermore, we found no significant difference in the effect on cognition between the two tested drugs and no difference in the results of the above-listed neuropsychological tests between the first and the last visits. KeyWords:Parkinson’s disease, Levo-dopa, Dopamine agonist, Cognitive function