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Titolo:
Estrogen improves motor disability in parkinsonian postmenopausal women with motor fluctuations
Autore:
Tsang, KL; Ho, SL; Lo, SK;
Indirizzi:
Univ Hong Kong, Univ Dept Med, Div Neurol, Hong Kong, Hong Kong, Peoples RChina Univ Hong Kong Hong Kong Hong Kong Peoples R China Kong, Peoples RChina Hong Kong Polytech Univ, Dept Rehabil Sci, Hong Kong, Peoples R China HongKong Polytech Univ Hong Kong Peoples R China Kong, Peoples R China
Titolo Testata:
NEUROLOGY
fascicolo: 12, volume: 54, anno: 2000,
pagine: 2292 - 2298
SICI:
0028-3878(20000627)54:12<2292:EIMDIP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
MPTP-INDUCED NEUROTOXICITY; DOPAMINE UPTAKE SITES; OVARIECTOMIZED RATS; C57/B1 MICE; DISEASE; ESTRADIOL; NEURONS; PROGESTERONE; DEPRESSION; RECEPTORS;
Keywords:
PD; postmenopausal; estrogen; motor fluctuations;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Ho, SL Univ Hong Kong, Queen Mary Hosp, Div Neurol, Hong Kong, Peoples R China Univ Hong Kong Hong Kong Peoples R China g Kong, Peoples R China
Citazione:
K.L. Tsang et al., "Estrogen improves motor disability in parkinsonian postmenopausal women with motor fluctuations", NEUROLOGY, 54(12), 2000, pp. 2292-2298

Abstract

Objective: To test the efficacy, tolerance, and safety of low-dose oral estrogen in postmenopausal women with PD associated with motor fluctuations. Background: Motor fluctuations in PD may be predictable or unpredictable, and eventually affect most patients after long-term levodopa therapy. Although estrogen can modulate nigrostriatal dopamine levels, its effects on PD are unclear. Methods: Patients were randomized to receive conjugated estrogen (oral Premarin 0.625 mg daily; n = 20) or placebo (n = 20) in a double-blind, parallel-group, prospective study over 8 weeks. Existing antiparkinsonian drug regimes were kept unchanged. Changes in "on" and "off" periods using patient diaries, Unified Parkinson's Disease Rating Scale (UPDRS) score,timed tapping score, and Hamilton Depression Scale score were determined by one rater. Subgroup analyses were also performed on patients with only predictable motor fluctuations. Results: Both treatment groups were similar in age, duration of disease and menopause, antiparkinsonian medication, and compliance with test medication and diary assessments. "On" and "off" times, and motor score (UPDRS subscale III) improved with estrogen, using the Mann-Whitney U test (p < 0.05 after Bonferroni adjustment). Mean "on" time improved by 7% (9 hours/week of awake time) in estrogen-treated patients versus a deterioration of 0.5% (1.4 hours) in placebo-treated patients (95% confidence interval, [CI] of mean difference, 5.73 to 14.9). Mean "off" time improved by 4% (4.4 hours/week of awake time) in estrogen-treated patients versus no change in placebo-treated patients (95% CI, 1.54 to 7.16). Mean subscale III score improved by 3.5 points in estrogen-treated patients versus0.4 in placebo-treated patients (95% CI, 1.02 to 5.18). No other significant changes were observed (p > 0.05). Subgroup analyses in patients with only predictable motor fluctuations showed similar results, except improvementin mean subscale III score was marginally not significant (p = 0.07; 95% CI, 1.06 to 6.24). Five patients on estrogen had facial flushing, three had lower abdominal discomfort, and two had mild withdrawal vaginal bleeding. The adverse events were mild and resolved without sequelae. Conclusion: Low-dose estrogen is a safe and effective adjunct therapy to existing antiparkinsonian treatment in reducing motor disability in postmenopausal women withPD associated with motor fluctuations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 13:10:31