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DOI: 10.1055/s-0042-1758753
Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease
Função pulmonar e efeitos da medicação em pessoas com doença de Parkinson em estágio leve Support The present study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; grant no. 441886/2014-0) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES; financial code no. 001).
Abstract
Background Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage.
Objective To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it.
Methods We included 21 patients with idiopathic PD and 20 healthy control subjects. The participants were submitted to spirometry and impulse oscillometry assessments. The PD patients were evaluated during the “off” and “on” phases of their anti-PD medication, which was was converted to levodopa in an equivalent daily dose. A statistical analysis was performed with cross-sectional (PD patients “off” medication versus controls) and paired (PD patients “off” medication versus PD patients “on” medication) tests. The effect of levodopa was calculated with partial Eta-squared (η2 ρ). Significance was set at 5%.
Results The PD patients presented normal values in the impulse oscillometry. Regarding spirometry, the results indicated an incipient obstructive ventilatory disorder in the PD group – confirmed by patients' flow-volume curves. The PD patients received a daily dose of 354.7 ± 148.2 mg of levodopa. The paired analyses showed a small effect of anti-PD medication on pulmonary parameters (η2 ρ = 0.197 for spirometry and η2 ρ= 0.043 for impulse oscillometry).
Conclusion Patients with PD in the mild stage of the disease present pulmonary compliance and resistance compatible with normal parameters. The differences regarding the spirometric results indicate an incipient obstructive ventilatory disorder in patients with PD. Levodopa had small effect on pulmonary function in the mild stage of the disease.
Resumo
Antecedentes A doença de Parkinson (DP) causa uma série de distúrbios do movimento, muitos deles se desenvolvendo na fase inicial.
Objetivo Analisar função pulmonar de pessoas com DP em estágio leve e investigar o efeito da levodopa nesse processo.
Métodos Vinte e um participantes com DP idiopática e vinte controles saudáveis foram incluídos na pesquisa. Todos os sujeitos foram submetidos a avaliações de espirometria e oscilometria de impulso. Participantes com DP foram avaliados nas fases ‘on’ e 'off' de medicação anti-parkinsoniana. A medicação dos pacientes foi convertida em dose diária de levodopa. A análise estatística foi realizada com testes transversais (Parkinson na fase ‘off’ da medicação vs controles) e pareados (Parkinson nas fases ‘off’ vs ‘on’ da medicação). O efeito da levodopa foi calculado pelo eta ao quadrado parcial (η2 ρ). Significância foi estipulada em 5%.
Resultados Pacientes com DP apresentaram valores normais na oscilometria de impulso. Na espirometria, os resultados indicaram uma desordem ventilatória obstrutiva incipiente no grupo DP – confirmada pelas curvas fluxo-volume dos pacientes. Pacientes com DP receberam uma dose diária de 354,7 ± 148,2 miligramas de levodopa. Análises pareadas mostraram baixo impacto da medicação anti-parkinsoniana nos parâmetros pulmonares (η2 ρ = 0,197 na espirometria e η2 ρ = 0,043 na oscilometria de impulso).
Conclusão Pacientes com DP na fase leve apresentam complacência e resistência pulmonares compatíveis com parâmetros normais. Diferenças espirométricas indicam distúrbio ventilatório obstrutivo incipiente em pacientes com DP. A administração de levodopa apresentou baixo efeito na função pulmonar na fase leve da doença.
Keywords
Parkinson Disease - Pulmonary Ventilation - Respiratory Function Tests - Spirometry - OscillometryPalavras-chave
Doença de Parkinson - Ventilação Pulmonar - Testes de Função Respiratória - Espirometria - OscilometriaAuthors' Contributions
RTO, FMS, PTM, GC: research idea and study design; RTO, FMS, AGR, KLMS: data acquisition; KLMS, PTM, GC: data analysis/interpretation; all authors: writing and editing. GC: funding acquisition.
Publikationsverlauf
Eingereicht: 21. Oktober 2021
Angenommen: 09. Januar 2022
Artikel online veröffentlicht:
29. Dezember 2022
© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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