Have We Been Overestimating Levodopa-Resistant Tremor Prevalence in Parkinson Disease?

A new analysis suggests that fewer patients have levodopa-unresponsive tremors.

Previous research has suggested that 20% or more of people with Parkinson disease (PD) may have levodopa-resistant tremor. Researchers have now performed a retrospective study to assess the prevalence of levodopa-resistant tremor among 526 people with advanced PD who were being screened for deep brain stimulation. As part of this screening, patients were assessed for symptoms after an overnight dopaminergic medication withdrawal and after receipt of a 120% levodopa-equivalent medication dose.

From the off-medication to the on-medications conditions, improvement in tremor (86.8%) was significantly higher than improvements in bradykinesia (45.7%) and rigidity (67.0%). Tremor was fully resolved with medication (67.9%) significantly more often t…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)