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@ARTICLE{PtterNerger:272840,
author = {Pötter-Nerger, Monika and Schrader, Christoph and Jost,
Wolfgang H and Höglinger, Günter},
title = {{T}he akinetic crisis in {P}arkinson's disease - the upper
end of a spectrum of subacute akinetic states.},
journal = {Journal of neural transmission},
volume = {131},
number = {10},
issn = {0375-9245},
address = {Wien [u.a.]},
publisher = {Springer},
reportid = {DZNE-2024-01258},
pages = {1199 - 1207},
year = {2024},
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.},
subtyp = {Review Article},
keywords = {Humans / Parkinson Disease: drug therapy / Parkinson
Disease: complications / Parkinson Disease: physiopathology
/ Parkinson Disease: diagnosis / Antiparkinson Agents:
therapeutic use / Levodopa / Drug Resistance / Akinetic
crisis (Other) / Cytokines (Other) / Neuroleptic
malignant-like syndrome (Other) / Parkinsonism-hyperpyrexia
syndrome (Other) / Parkinson’s disease (Other) / Risk
factors (Other) / Spectrum acute akinetic states (Other) /
Therapy (Other) / Antiparkinson Agents (NLM Chemicals) /
Levodopa (NLM Chemicals)},
cin = {AG Höglinger / Clinical Research (Munich)},
ddc = {610},
cid = {I:(DE-2719)1110002 / I:(DE-2719)1111015},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39153024},
pmc = {pmc:PMC11489269},
doi = {10.1007/s00702-024-02817-8},
url = {https://pub.dzne.de/record/272840},
}