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Levodopa challenge test: indications, protocol, and guide

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Abstract

A drug challenge test in Parkinson’s disease, such as the levodopa challenge test (LCT), is an easy and generally safe procedure, which has been used by clinicians for various indications. The results of the test have significant implications in the management of patients, from preoperative evaluation for deep brain stimulation to providing the basis for medication adjustments to address motor or non-motor fluctuations and dyskinesias. This paper reviews the different indications and protocols commonly used in an acute LCT. Potential complications of the procedure and an overview of levodopa responsiveness and unresponsiveness are also discussed.

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Funding

This study was supported in part by the Parkinson’s Foundation through its support of the fellowship training of G.S.

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Author notes

  1. Anthony E. Lang

    Present address: Movement Disorders Clinic, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

Authors and Affiliations

  1. Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada

    Gerard Saranza & Anthony E. Lang

  2. Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada

    Anthony E. Lang

Authors
  1. Gerard Saranza
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  2. Anthony E. Lang
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GS performed a detailed review of the literature and undertook the writing of the manuscript. AEL provided critical comments, recommendations, and editorial contributions.

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Correspondence to Anthony E. Lang.

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The article is based on previously published studies and patient data and is in line with the journal's ethical guidelines.

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Saranza, G., Lang, A.E. Levodopa challenge test: indications, protocol, and guide. J Neurol 268, 3135–3143 (2021). https://doi.org/10.1007/s00415-020-09810-7

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