Journal Article (Review Article)

DZNE-2024-01258

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png The akinetic crisis in Parkinson's disease - the upper end of a spectrum of subacute akinetic states.

Pötter-Nerger, M. ; Schrader, C. ; Jost, W. H. ; Höglinger, G. (Last author)DZNE*

2024
Springer Wien [u.a.]

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Please use a persistent id in citations: doi:10.1007/s00702-024-02817-8

Abstract: The akinetic crisis is defined as an acute, potentially life-threatening, levodopa-resistant, severe aggravation of rigidity, severe akinesia, associated with high fever, disturbance of consciousness, dysphagia and autonomic symptoms often due to disruption of dopaminergic medication or infections. The akinetic crisis is a relatively rare event, however subacute mild-moderate motor symptom deterioration in Parkinson´s disease (PD) patients is a frequent cause of hospitalization. In this review, we propose that the akinetic crisis is the upper end of a continuous spectrum of acute akinetic states depending on the degree of the progressive levodopa-resistance. Clinical symptomatology, risk factors, and instrumental diagnostics as the DAT-SPECT reflecting a biomarker of levodopa-resistance will be discussed to evaluate the spectrum of akinetic states. Pathophysiological considerations about the potential role of proinflammatory cytokines on the progressive levodopa-resistance will be discussed and therapeutical, consensus-based guidelines will be presented.

Keyword(s): Humans (MeSH) ; Parkinson Disease: drug therapy (MeSH) ; Parkinson Disease: complications (MeSH) ; Parkinson Disease: physiopathology (MeSH) ; Parkinson Disease: diagnosis (MeSH) ; Antiparkinson Agents: therapeutic use (MeSH) ; Levodopa (MeSH) ; Drug Resistance (MeSH) ; Akinetic crisis ; Cytokines ; Neuroleptic malignant-like syndrome ; Parkinsonism-hyperpyrexia syndrome ; Parkinson’s disease ; Risk factors ; Spectrum acute akinetic states ; Therapy ; Antiparkinson Agents ; Levodopa

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Contributing Institute(s):

1. Translational Neurodegeneration (AG Höglinger)
2. Clinical Research (Munich) (Clinical Research (Munich))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2024

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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