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Effects of Dihydropyridines on the Motor and Cognitive Outcomes of Patients with Parkinson's Disease

 Jin Ho Jung  ;  Han Kyu Na  ;  Seong Ho Jeong  ;  Seok Jong Chung  ;  Han Soo Yoo  ;  Yang Hyun Lee  ;  Kyoungwon Baik  ;  Sang Jin Kim  ;  Young H Sohn  ;  Phil Hyu Lee 
 MOVEMENT DISORDERS, Vol.38(5) : 843-853, 2023-05 
Journal Title
Issue Date
Antiparkinson Agents / adverse effects ; Cognition ; Dihydropyridines* / therapeutic use ; Dopamine Plasma Membrane Transport Proteins ; Dyskinesias* / drug therapy ; Humans ; Hypertension* / drug therapy ; Levodopa / adverse effects ; Parkinson Disease* / complications ; Parkinson Disease* / drug therapy
Parkinson's disease ; calcium channel blocker ; dementia ; dihydropyridine
Background: Dihydropyridines (DHPs) may have neuroprotective effects against Parkinson's disease (PD).

Objective: This study investigated the effects of DHPs on nigrostriatal dopaminergic denervation and longitudinal motor and cognitive outcomes in PD.

Methods: We classified 476 patients with drug-naive PD who had undergone dopamine transporter imaging into three groups. They were selected according to a prior diagnosis of hypertension and use of DHPs and were matched using propensity scores: patients without hypertension (HTN-; n = 50) and patients with hypertension treated without DHP (HTN+/DHP-; n = 50) or with DHP (HTN+/DHP+; n = 50). Multiple linear regression and linear mixed model analyses were performed to determine intergroup differences in baseline dopamine transporter availability and longitudinal changes in the levodopa-equivalent dose, respectively. Using Kaplan-Meier analyses, we compared the risks of levodopa-induced dyskinesia, wearing off, and dementia-free survival during the 5.06 years of the mean follow-up period. The Cox regression model determined the independent effects of DHPs on dementia conversion.

Results: Dopamine transporter availability in all striatal subregions was comparable between the HTN-, HTN+/DHP-, and HTN+/DHP+ groups. The risks of levodopa-induced dyskinesia and wearing off, as well as longitudinal changes in the levodopa-equivalent dose, did not differ between the groups. The HTN+/DHP+ group had a lower risk of developing dementia than the HTN+/DHP- (Bonferroni-corrected Plog-rank = 0.036) group. The use of DHP was independently associated with a lower risk of dementia conversion after controlling for other antihypertensive drugs and confounding factors (hazard ratio, 0.242; 95% confidence interval, 0.087-0.668; P = 0.006).

Conclusions: DHPs may be associated with better long-term cognitive outcomes in hypertensive patients with PD. © 2023 International Parkinson and Movement Disorder Society.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Na, Han Kyu(나한규)
Baik, Kyoungwon(백경원) ORCID logo https://orcid.org/0000-0001-7215-375X
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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