Levodopa versus non-levodopa brain language fMRI in Parkinson's disease

OBJECTIVE: To identify the effect of levodopa in language areas in Parkinson's disease patients. METHODS: We evaluated 50 patients with mild to moderate Parkinson's disease, age and gender paired to 47 healthy volunteers. We selected two homogeneous groups of 18 patients taking levodopa and 7 no levodopa patients. The functional magnetic resonance imaging verbal fluency task, with low and high cognitive demands, was performed at a 3T magnetic resonance imaging equipment. Data was analyzed with XBAM software for group maps and ANOVA comparison. RESULTS: Patients without levodopa had more activation than the ones with levodopa in the medial frontal and in the left frontal and parieto-occipital areas. The striatal activation in patients taking levodopa had similar result of the activation detected in the healthy volunteer group. Parieto-occipital areas were less activated in the levodopa group than in the no levodopa one. CONCLUSION: Parkinson's disease patients without levodopa replacement, during a verbal fluency effort, had more diffuse and intense cerebral activation in left hemisphere, mainly in the frontal and parieto-occipital areas. The striatal activation in verbal fluency of patients with levodopa intake was more similar to the activation found in healthy volunteers. These initial evidences suggested a role of levodopa inhibiting activation in parieto-occipital compensating areas.

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Bibliographic Details
Main Authors: Arantes,Paula Ricci, Gobato,Heloise Helena, Davoglio,Bárbara Bordegatto, Barreiros,Maria Ângela Maramaldo, Felício,André Carvalho, Barsottini,Orlando Graziani Povoas, Andrade,Luiz Augusto Franco de, Amaro Junior,Edson
Format: Digital revista
Language:English
Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2012
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082012000200010
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Summary:OBJECTIVE: To identify the effect of levodopa in language areas in Parkinson's disease patients. METHODS: We evaluated 50 patients with mild to moderate Parkinson's disease, age and gender paired to 47 healthy volunteers. We selected two homogeneous groups of 18 patients taking levodopa and 7 no levodopa patients. The functional magnetic resonance imaging verbal fluency task, with low and high cognitive demands, was performed at a 3T magnetic resonance imaging equipment. Data was analyzed with XBAM software for group maps and ANOVA comparison. RESULTS: Patients without levodopa had more activation than the ones with levodopa in the medial frontal and in the left frontal and parieto-occipital areas. The striatal activation in patients taking levodopa had similar result of the activation detected in the healthy volunteer group. Parieto-occipital areas were less activated in the levodopa group than in the no levodopa one. CONCLUSION: Parkinson's disease patients without levodopa replacement, during a verbal fluency effort, had more diffuse and intense cerebral activation in left hemisphere, mainly in the frontal and parieto-occipital areas. The striatal activation in verbal fluency of patients with levodopa intake was more similar to the activation found in healthy volunteers. These initial evidences suggested a role of levodopa inhibiting activation in parieto-occipital compensating areas.