Antisaccadic effects of a dopamine agonist as add-on therapy in advanced Parkinson's patients

We wanted to compare clinical neurological and antisaccadic behavior before and after addition of a dopamine agonist to the usual antiparkinsonian dru gs in advanced Parkinson's disease. Parkinson's patients in stage 3 and 4 o f Hoehn and Yahr not yet taking a dopamine agonist were selected, In 20 pat ients, the treating neurologist decided to add pergolide, The dose of pergo lide was adjusted by the treating neurologist according to clinical respons e, Antisaccades were studied by infrared oculography before and after addit ion of pergolide. Antisaccades are voluntary saccades in the opposite direc tion of an unanticipated visual target. The patients made more errors, i.e, they glanced to the target or they made no eye movement at all, In contrad istinction to the global neurological improvement and the better motor scor es, antisaccadic disturbances did not improve significantly with pergolide, except in younger patients, These findings suggest that antisaccadic alter ations in patients with advanced Parkinson's disease could be multifaceted, Not only depletion of dopamine, but also non-dopaminergic dysfunctions cou ld contribute, Cortical frontal lesions must also be taken into account, Co pyright (C) 2000 S. Karger AG, Basel.