Continuous Dopaminergic Stimulation in Parkinson’s Disease

1. Front Matter

   Pages I-XII

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2. Continuous dopaminergic stimulation in Parkinson’s disease

   1. Front Matter

      Pages 1-1

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   2. Pathogenetic studies of motor fluctuations in Parkinson’s disease

      • T. N. Chase, M. M. Mouradian, G. Fabbrini, J. L. Juncos

      Pages 3-10

   3. The case for and concerns about continuous dopamine stimulation in Parkinson’s disease

      • J. G. Nutt

      Pages 11-15

   4. Subcutaneous administration of lisuride in the treatment of complex motor fluctuations in Parkinson’s disease

      • J. A. Obeso, M. R. Luquin, J. Vaamonde, J. M. Martînez Lage

      Pages 17-25

   5. Subcutaneous lisuride infusion in Parkinson’s disease: clinical results using different modes of administration

      • F. Stocchi, S. Ruggieri, A. Antonini, F. Baronti, G. Brughitta, P. Bellantuono et al.

      Pages 27-33

   6. Chronic s.c. Lisuride in Parkinson’s disease — motorperformance and avoidance of psychiatric side effects

      • S. Bittkau, H. Przuntek

      Pages 35-54

   7. Continuous subcutaneous lisuride infusions in Parkinson’s disease

      • P. H. S. Critchley, F. Grandas Perez, N. P. Quinn, J. D. Parkes, C. D. Marsden

      Pages 55-60

   8. A combined regimen of subcutaneous lisuride and oral Madopar HBS in Parkinson’s disease

      • C. Chouza, J. L. Caamaño, Ofrenda de Medina, Ruth Aljanati, A. Scaramelli, Susana Romero

      Pages 61-70

   9. Pharmacokinetics of lisuride after subcutaneous infusion

      • W. Krause, B. Nieuweboer, St. Ruggieri, F. Stocchi, I. Suchy

      Pages 71-74

   10. Treatment of Parkinson’s disease with subcutaneous lisuride infusions

       • M. Fernandez Pardal, Federico Micheli, Mabel Gatto, Natividad Perez y Gonzalez

       Pages 75-84

   11. Lisuride infusion pump in Parkinson’s disease. A report of two cases

       • O. S. Gershanik, O. Scipioni, Silvia García

       Pages 85-90

3. Complications in treatment

   1. Front Matter

      Pages 115-115

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   2. Psychiatric side effects during the treatment of Parkinson’s disease

      • H. L. Klawans

      Pages 117-122

   3. Applications of new drug delivery technologies to Parkinson’s disease and dopaminergic agents

      • S. M. Stahl

      Pages 123-132

4. Continuous dopaminergic stimulation experimental studies

   1. Front Matter

      Pages 139-139

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   2. Continuous intracerebroventricular infusion of dopamine and dopamine agonists through a totally implanted drug delivery system in animal models of Parkinson’s disease

      • J. G. de Yebenes, S. Fahn, V. Jackson-Lewis, P. Jorge, M. A. Mena, J. Reiriz

      Pages 141-160

   3. Receptor changes during chronic dopaminergic stimulation

      • P. Jenner, S. Boyce, C. D. Marsden

      Pages 161-175

   4. Effect of chronic subcutaneous minipump infusion of lisuride upon locomotor activity of rats

      • H. Wachtel, K.-J. Rettig, P.-A. Löschmann

      Pages 177-183

5. Biochemical basis of diagnostic and therapeutic problems

   1. Front Matter

      Pages 189-189

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At this meeting, a number of critical groups confirmed and extended the original findings by J.A. Obeso and his colleagues. These authors found that continuous s.c. infusion of lisuride, a watersoluble dopaminergic 8- -aminoergoline with dopaminergic properties which can be injected or infused, can improve - sometimes quite considerably - motor function in severely disabled fluctuating Parkinsonian patients. The concurrent use of the peripheral dopamine antagonist domperidone attenuates or prevents side effects related to the stimulation of "peripheral" dopamine receptors, including the chemoreceptor trigger zone and some areas of the hypothalamus outside the blood-brain barrier. The clinical results discussed in this volume may not only be a basis for further improvements in our knowledge and therapeutic strategies in Parkinsonism, they point to the so far neglected importance of different ways of stimulating neurological or other systems, e.g. discontinous, oscillatory effects caused by frequent oral application vs. continuous stimulation as described here with the lisuride s.c. infusion. Similar concepts have to be discussed and investigated in neurological disorders. In this respect, this multidisciplinary meeting and its publication may offer new ideas and concepts for therapy in general, in addition to its potential application in the treatment of the complications of Parkinson's disease.

• PET
• Parkinson
• brain
• dopamine
• drug
• drug delivery
• kinetics
• pharmacokinetics
• positron emission tomography (PET)
• research
• therapy

• Clinica Universitaria, Pamplona, Spain

  J. A. Obeso

• HA Klinische Forschung II, Schering AG, Berlin, Germany

  R. Horowski

• University Department of Clinical Neurology, The National Hospital for Nervous Diseases, London, UK

  C. D. Marsden

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