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A Preliminary Report

Patricia J. Karstaedt, MD; Jonathan H. Pincus, MD; Steven S. Coughlin, PhD

Arch Neurol. 1991;48(4):402-405.

Abstract
• Ten patients with Parkinson's disease (PD) with motor fluctuations that responded to a protein redistribution diet were studied. All 10 patients were receiving standard Sinemet (levodopa/carbidopa). Five randomly selected patients were changed from standard Sinemet to a controlled-release form of Sinemet. The other five patients continued to receive standard Sinemet. To maintain the same degree of control of PD in the five patients switched to the controlled-release form of Sinemet, the daily levodopa intake increased. While receiving optimal therapy (standard Sinemet or controlled-release Sinemet) and a protein redistribution diet, all 10 patients then underwent hourly videotaping and blood sampling (for plasma levodopa levels) during 2 consecutive days. Videotapes were blindly reviewed for PD disability, dyskinesia, and the time required to walk a measured distance. Comparing the two groups, standard Sinemet with controlled-release Sinemet, respectively, mean levodopa requirements were 505 and 1895 mg, plasma levodopa levels were 6.1 and 17.6 µmol/L, and abnormal involuntary movement scale scores were 14 and 26. Their mean PD disability scores did not differ statistically or clinically. Also no statistically significant differences were noted in either their mean walking times or their mean daily dose frequencies.

Author Affiliations
From the Department of Neurology, Georgetown University Hospital (Drs Karstaedt and Pincus), and the Division of Biostatistics and Epidemiology, Department of Community and Family Medicine, Georgetown University School of Medicine (Dr Coughlin), Washington, DC.

Footnotes
Accepted for publication October 30, 1990.

Read before the 42nd Annual Meeting of the American Academy of Neurology, Miami Beach, Fla, May 5,1990.

Reprint requests to Department of Neurology, Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007-2197 (Dr Pincus).

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