The angiotensin converting enzyme (ACE) inhibitor, perindopril, modifies the clinical features of Parkinson's disease
Adult
0301 basic medicine
Cross-Over Studies
Angiotensin-Converting Enzyme Inhibitors
Parkinson Disease
Pilot Projects
Middle Aged
3. Good health
Levodopa
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Perindopril
Humans
Aged
DOI:
10.1111/j.1445-5994.2000.tb01054.x
Publication Date:
2008-03-25T09:31:26Z
AUTHORS (4)
ABSTRACT
Abstract Background: Animal studies have demonstrated an interaction within the striatum between the angiotensin and dopaminergic systems. In rats, the angiotensin converting enzyme (ACE) inhibitor, perindopril, crosses the blood brain barrier and increases striatal dopamine synthesis and release. In humans, angiotensin type 1 receptors have been found on dopaminergic neurons in the substantia nigra and striatum. In Parkinson's disease, there is a marked reduction of these receptors associated with the nigrostriatal dopaminergic neuron loss. Aims: We performed a double blind placebo controlled crossover pilot study in seven patients to investigate the effect of the ACE inhibitor, perindopril on the clinical features of moderately severe Parkinson's disease. Results: After a four week treatment period with perindopril, patients had a faster onset in their motor response to L‐dopa and a reduction in ‘on phase’ peak dyskinesia, p=0.021 and p=0.014 respectively. Patients also reported more ‘on’ periods during their waking day in their movement diary, p=0.007. Perindopril was well tolerated without any significant postural hypotension or renal dysfunction. Conclusions: These results suggest that ACE inhibitors such as perindopril may have a place in the management of motor fluctuations and dyskinesia in Parkinson's disease and justify further study.
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