パーキンソン病におけるL-threo−3,4—dihydroxyphenylserine療法の効果の分析

Analysis of L-Threo-3, 4-Dihydroxyphenylserine Effect on Motor and Psychological Symptoms in Parkinson's Disease

　すくみ足歩行，姿勢保持障害を主とした20例のパーキンソン病症例に対してL-DOPS 400〜1200mgを投与し，その効果の分析を行った。1例の純粋無動症の症例を除いて全例長期L-DOPA療法下にあり，L-DOPSはL-DOPA＋DCIに併用して投与された。臨床症状の観察はすくみ足を中心とする歩行障害とうつ状態を主とする精神症状について行い，後者については心理測定的方法も併用した。約2／3の症例において歩行，姿勢反射の障害が著しく改善され，それと共にうつ傾向や注意集中力も改善した。その効果は主として古典的パーキンソン病の症例において著明であり，若年発症例においてはほとんど効果は認められなかった。本病の病像の分析においてNE代謝障害のもつ役割を論じた。

Improvement of motor and psychological symp-toms by L - DOPS ( L-threo-3,4-dihydroxy-phenylserine) in totally 20 cases with Parkinson's disease (PD), including 5 cases of juvenile or early onset parkinsonism (JP) and one case of pure akinesia was analysed. Improvement was obtained in about two thirds of the cases on symptoms of freezing in gait, difficulty of postural control, depressive mood and bradyphrenia. Severity of freezing in gait and that of the depressive mood were graded in five stage (from 0 to 4) scale and the improvement was evaluated by A (three stage improvement) , B (two stage improvement), C (one stage improvement) and D (no change or wor-sened). Improvement of psychological symptoms was seen parallel to that of motor symtoms. It seems important that marked effect on both motor and psychological symptoms was obtained mostly in PD cases but not in the cases of JP. In MMPI test, depressive score (D) and hypochondric score (Hs) were normalized in PD cases but not changed in JP, indicating differences in psychological traits between two groups. It was suggested that JP is a condition of mainly DA deficiency in nigrostriatum but PD presents wider spectrum of symptoms cover-ing both DA and NE deficieny. Importance of the role of aging of the brain in each individual patient is discussed and interpreted in relation to the difference of clinical pictures.