Acute and Long-Term Administration of Anticholinergics in Parkinson's Disease: Specific Effects on the Subcortico-Frontal Syndrome

Parkinson's Disease (PD) is often associated with a subcortico-frontal syndrome (SCFS) that is mainly characterized by executive dysfunctions. The complete biochemistry of these dysfunctions remain misunderstood. Most studies have focused on the well-known nigro-striatal dopaminergic degenerati...

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Bibliographic Details
Published in:Brain and cognition 1999-07, Vol.40 (2), p.289-313
Main Authors: Bédard, M.A., Pillon, B., Dubois, B., Duchesne, N., Masson, H., Agid, Y.
Format: Article
Language:English
Subjects:
Acute Disease
Cholinergic Antagonists - therapeutic use
Cognition Disorders - chemically induced
Cognition Disorders - diagnosis
Corpus Striatum - pathology
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Humans
Levodopa - therapeutic use
Middle Aged
Nerve Degeneration
Neuropsychological Tests
Parkinson Disease - drug therapy
Parkinson Disease - pathology
Scopolamine Hydrobromide - adverse effects
Severity of Illness Index
Substantia Nigra - pathology
Syndrome
Time Factors
Trihexyphenidyl - adverse effects
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Summary:Parkinson's Disease (PD) is often associated with a subcortico-frontal syndrome (SCFS) that is mainly characterized by executive dysfunctions. The complete biochemistry of these dysfunctions remain misunderstood. Most studies have focused on the well-known nigro-striatal dopaminergic degenerations of PD, but a more satisfying understanding of the SCFS has come from the study of the cholinergic systems. We present here two new experiments carried out with long-term and acute anticholinergic treatments in PD. In the first experiment, the effects of a 2-week treatment with trihexyphenidyl were compared to those observed under placebo on a neuropsychological battery. Results showed that anticholinergic-induced deficits in PD were exclusively concerned with executive functions. In the second experiment, the effects of an acute subclinical dose of scopolamine were compared between normal controls and PD patients who were devoid of cognitive deficit on a subset of executive tasks. Results indicates that PD patients but not normal controls developed a transient SCFS for the duration of the drug action. In contrast to other populations with cholinergic depletions—such as Alzheimer's disease—cholinergic blockade in PD exacerbates specifically the SCFS. Such a discrepancy between these two neuropsychological profiles are discussed in terms of the specificity of the underlying cholinergic lesions.
ISSN:0278-2626
1090-2147
DOI:10.1006/brcg.1999.1083