Response of non-motor symptoms to levodopa in late-stage Parkinson's disease: Results of a levodopa challenge test

Abstract Background Non-motor symptoms (NMS) are extremely common among late-stage Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to decrease with disease progression but its effect on NMS in LSPD still needs to be investigated. Objective To assess the response of blood pressure (BP), pain, fatigue and anxiety to L-dopa in LSPD patients. Methods 20 LSPD patients, defined as Schwab and England ADL Scale 3 (MED ON) and 22 PD patients treated with subthalamic deep brain stimulation (advanced PD group) underwent an L-dopa challenge. BP and orthostatic hypotension (OH) assessment, a visual analogue scale (VAS) for pain and fatigue and the Strait Trait Anxiety (STAI) were evaluated before and after the L-dopa challenge. Results Systolic BP dropped significantly after L-dopa intake (p