Levodopa and neuropathy risk in patients with Parkinson disease: Effect of COMT inhibition

Cossu, G;Ceravolo, R;Zibetti, M;ARCA, ROBERTA;Ricchi, V;PARIBELLO, ALESSANDRA;MURGIA, DANIELA;Merola, A;Romagnolo, A;Nicoletti, V;Palermo, G;MEREU, ALESSANDRA;Lopiano, L;Melis, M;Abbruzzese, G;Bonuccelli, U.

2016-01-01

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Abstract

Objective: Our purpose was to determine whether the use of catechol-O-methyltransferase-inhibitors (ICOMT) can reduce the risk of developing levodopa (LD)-induced neuropathy in Parkinson's disease (PD) patients. Methods: A multicentre study of 197 PD patients was performed. 144 were exposed to LD for more than three years (LELD group); 53 simultaneously assumed Entacapone for at least eighteen months (LELD_ICOMT group). Results: The prevalence of neuropathy in LELD patients was 19.4% whereas it was 5.7% in LELD_ICOMT group with a significant difference (p = 0.025). In LELD_ICOMT cohort the daily LD dose and serum VB12 levels were significantly higher (p < 0.0001), the serum Hcy levels were significantly lower (p = 0.001) compared to LELD group. Conclusion: Our results suggest that ICOMT could have a protective effect on the development of LD-induced neuropathy. Their action probably occurs through the metabolic rebalancing of the one-carbon-pathway cycle and is independent of the PD duration and severity and the duration of LD intake