Aktuelle Neurologie 2005; 32: 45-49
DOI: 10.1055/s-2004-834696
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Apomorphintest

Apomorphine TestK.  Eggert1 , W.  H.  Oertel1
  • 1Neurologische Klinik, Philipps-Universität Marburg
Further Information

Publication History

Publication Date:
26 April 2005 (online)

Zusammenfassung

Die therapeutische Wirksamkeit von Apomorphin auf die Kardinalsymptome der Parkinson-Krankheit ist bereits seit 120 Jahren bekannt. Seit Ende der 80er-Jahre wird die subkutane Injektion von Apomorphin zu diagnostischen Zwecken eingesetzt. Der Apomorphintest dient der Beurteilung der Effektivität einer dopaminergen Therapie sowie der Diagnoseüberprüfung bei Patienten mit neu aufgetretenem oder atypisch verlaufendem Parkinson-Syndrom. Der folgende Beitrag fasst die Anwendung des Apomorphintests im klinischen Alltag sowie die Ergebnisse einer Metaanalyse zur diagnostischen Wertigkeit des Apomorphintests zusammen.

Abstract

The therapeutical efficacy of apomorphine on the cardinal motor symptoms of Parkinson's disease is well known since 120 years. By the late eighties the subcutaneous injection of apomorphine was used for the first time in the assessment of parkinsonian patients. Since then the apomorphine test is performed to determine dopaminergic responsiveness as part of a pre-treatment assessment or in differential diagnosis of parkinsonian syndromes. We summarize here the clinical management of the apomorphine test as well as the results of a meta-analysis on the diagnostic use of apomorphine in parkinsonian patients.

Literatur

  • 1 Gancher S T, Woodward W R, Boucher B, Nutt J G. Peripheral pharmacokinetics of apomorphine in humans.  Ann Neurol. 1989;  26 232-238
  • 2 Poewe W, Wenning G K. Apomorphine: An underutilized therapy for Parkinson's disease.  Mov Disord. 2000;  15 789-794
  • 3 Barker R, Duncan J, Lees A J. Subcutaneous apomorphine as a diagnostic test for dopaminergic responsiveness in Parkinsonian syndromes.  Lancet. 1989;  1 675-678
  • 4 Oertel W H, Gasser T, Ippisch R. et al . Apomorphine test for dopaminergic responsiveness.  Lancet. 1989;  1 1262-1263
  • 5 Hughes A J, Lees A J, Stern G M. Apomorphine test to predict dopaminergic responsiveness in parkinsonian syndromes.  Lancet. 1990;  336 32-34
  • 6 D'Costa D F, Abbott R J, Pye I F, Millac P AH. The apomorphine test in parkinsonian syndromes.  J Neurol Neurosurg Psychiatry. 1991;  54 870-872
  • 7 Hughes A J, Lees A J, Stern G M. Challenge tests to predict the dopaminergic response in untreated Parkinson's disease.  Neurology. 1991;  41 1723-1725
  • 8 Bonuccelli U, Piccini P, Dotto P Del. et al . Apomorphine test in de novo Parkinson's disease.  Funct Neurol. 1992;  7 295-298
  • 9 Gasser T, Schwarz J, Arnold G. et al . Apomorphine test for dopaminergic responsiveness in patients with previously untreated Parkinson's disease.  Arch Neurol. 1992;  49 1131-1134
  • 10 Bonuccelli U, Piccini P, Dotto P Del. et al . Apomorphine test for dopaminergic responsiveness: a dose assessment study.  Mov Disord. 1993;  8 158-164
  • 11 Schelosky L, Hierholzer J, Wissel J. et al . Correlation of clinical response in apomorphine test with D2-receptor status as demonstrated by I123IBZM-SPECT.  Mov Disord. 1993;  8 453-458
  • 12 Ward C D, Gibb W RG. Research diagnostic criteria for Parkinson's disease.  Adv Neurol. 1990;  53 245-249
  • 13 Rajput A H, Rozdilsky B, Rajput A, Ang L. Levodopa efficacy and pathological basis of Parkinson syndrome.  Clin Neuropharmacol. 1990;  13 553-558
  • 14 Levitan I, Mangone C A, McKee A. et al . Natural history of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) and clinical predictors of survival: a clinicopathological study.  J Neurol Neurosurg Psychiatry. 1996;  61 615-620
  • 15 Wenning C, Ben-Shlomo Y, Magalhaes M. et al . Clinicopathological study of 35 cases of multiple system atrophy.  J Neurol Neurosurg Psychiatry. 1995;  58 160-166
  • 16 Hughes A J. Apomorphine test in the assessment of parkinsonian patients: a meta-analysis.  Adv Neurol. 1999;  80 363-368
  • 17 Rossi P, Colosimo C, Moro E. et al . Acute challenge with apomorphin and levodopa in parkinsonism.  Eur Neurol. 2000;  43 95-101
  • 18 Hilten J J van, Wagemans E A, Ghafoerkhan S F, Laar T van. Movement characteristics in Parkinson's disease: determination of dopaminergic responsiveness and threshold.  Clin Neuropharmacol. 1997;  20 402-408
  • 19 Martinez-Martin P, Garcia Urra D, Balseiro Gomez J. Timed tests in Parkinson's disease evaluation.  Mov Disord. 1997;  12 127-128
  • 20 Defer G L, Widner H, Marie R M. et al . Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD).  Mov Disord. 1999;  14 572-584
  • 21 Goetz C G, Stebbins G T, Chumura T A. et al . Teaching tape for the motor section of the unified Parkinson's disease rating scale.  Mov Disord. 1995;  10 263-266
  • 22 Hagell P. Timed tests in clinical assessment of motor function in Parkinson's disease.  J Neurosci Nurs. 2000;  32 331-336
  • 23 Jankovic J, Rajput A H, McDermott M P, Perl D P. The evolution of diagnosis in early Parkinsons disease. Parkinson Study Group.  Arch Neurol. 2000;  57 369-372
  • 24 Meara J, Bhowmick B K, Hobson P. Accuracy of diagnosis in patients with presumed Parkinson's disease.  Age Ageing. 1999;  28 99-102
  • 25 Fearnley J M, Lees A J. Ageing and Parkinson's disease: substantia nigra regional selectivity.  Brain. 1991;  114 2283-2301
  • 26 Gibb W R, Lees A J. The significance of the Lewy body in the diagnosis of idiopathic Parkinson's disease.  Neuropathol Appl Neurobiol. 1989;  15 27-44
  • 27 D'Costa D F, Sheehan L J, Phillips P A, Moore-Smith B. The levodopa test in Parkinson's disease.  Age Ageing. 1995;  24 210-212
  • 28 Zappia M, Montesanti R, Colao R. et al . Short-term levodopa test assessed by movement time accurately predicts dopaminergic responsiveness in Parkinson's disease.  Mov Disord. 1997;  12 103-106

Dr. med. Karla Eggert

Neurologische Klinik · Philipps-Universität Marburg

Rudolf-Bultmann-Straße 8

35039 Marburg

Email: eggert@med.uni-marburg.de

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