I recall that someone asked about this before but I don't recall an answer.

I notice that when I awaken in the morning, after some initial movement problems, I am much better than I am for the rest of the day and can move around much more easily. In contrast, the evenings are much more difficult after the last doses have worn off.

Does dopamine accumulate over night? Does movement use up dopamine? If so, wouldn't exercise use it faster? Is there something about sleeping that builds a dopamine reserve? Is this a common experience? Does it mean that the dopaminergic cells are still there but during the day something is preventing them from working? Maybe whatever hormonal/neurotransmitter imbalances are present during awakened periods is normalized during sleep.

+Gerry, all good questions.

Bear in mind that everyone is different, but my experiences are:

1. Does dopamine accumulate over night? Yes. In the mornings I feel good, but will go "off" later unless I take my meds.

2. Does movement use dopamine? Yes. Try touching together your thumb and finger. After a few seconds of doing it quickly, if you have PD, you will begin to slow down. This seems to be a local deficiency - I can repeat walking strides thousands of times with no problems. After walking about 10 miles I feel a general need for levodopa.

3. Does it mean that dopaminergic neurons are still there? Yes, but fewer than before. Not only does dopamine generation suffer, but the ability to store excess in vesicles is reduced.

Questions that this raise are?

1. Does exercise generate more dopamine or make you use it more efficiently?

2. Does differential exercise rechannel dopamine production and storage.

I've been running the side-to-side tap test for some time.

http://www.parkinsonsmeasurement.org/PDMeasure/

PDMeasure allows you to take the test online and store the results.

My performance has improved over time. Some of this improvement has been to do with learning to pass the test. But, I think some is to do with real, local improvements.

John

A couple of more related questions:

Would taking a nap during the day result in extended on time after the nap?

Would taking some levodopa at bedtime influence the morning functionalty?

Anyone notice this?

A nap in the day just ruins it or me. I wake up off and have to start trudging up the mountain again. Ldopa at bedtime, however, does make the morning brighter. I also sometimes indulge myself with a partial dose an hour before getting up and luxuriate in pretending that I am cured.