Brief Report
Worsening of motor performance in patients with Parkinson's disease following transdermal nicotine administration
http://www3.interscience.wiley.com/c...09386/ABSTRACT

Georg Ebersbach, Michael Stöck, Jörg Müller, Gregor Wenning, Jörg Wissel, Werner Poewe *
Department of Neurology, University Clinic Innsbruck, Innsbruck, Austria

*Correspondence to Werner Poewe, University Clinic Innsbruck, Dept. of Neurology, Anichstr. 35, 6020 Innsbruck, Austria

Funded by:
VERUM Foundation, Munich, Germany

Keywords
Parkinson's disease; Nicotine; Motor performance

Abstract
Nicotine has been reported to have positive effects on motor performance in patients with Parkinson's disease. In this study, motor performance was evaluated in 16 patients with idiopathic Parkinson's disease during a practical off-period using the motor part of the Unified Parkinson's Disease Rating Scale after 12 hours' exposure to a transdermal patch containing 35 mg nicotine or placebo. The study was performed using a double-blind crossover design. In contrast to previous reports, nicotine exposure was followed by a worsening of symptoms compared with placebo. A negative response to subthreshold dopaminergic stimulation, resulting from an inhibitory effect of low striatal dopamine concentrations acting on a subset of dopamine receptors, might possibly account for this finding.

Received: 19 August 1998; Revised: 31 March 1999; Accepted: 12 July 1999