Levodopa, parkinsonism, and recent memory.

Abstract

Much controversy has existed concerning behavioral changes attributed to L-dopa treatment in parkinsonian patients. Disagreement existed pertaining to the question of whether improved functioning was temporally limited. The present study proposed to research the shorter and longer range effects of L-dopa onmemory. It was hypothesized that equated nonparkinsonian individuals would perform better than parkinsonian patients on all memory measures, and that shorter range L-dopa would perform better than longer range L-dopa patients. It was also hypothesized that the greater the functional deficiency, and the greater the symptom severity, the poorer memory functioning would be. Level of dosage was hypothesized to have no differential effect on memory functioning. Three groups of 20 subjects were tested. The short term (20 parkinsonian patients on L-dopa for 22 months or less) and the long term (20 parkinsonian patients on L-dopa for 40 months or more) patients were chosen from the neurological clinic at St. Barnabas Hospital, Bronx, N.Y. Testability was assessed by the neurologis and by WAIS Vocabulary performance. The third group consisted of spouses of the patients. All groups were equated with regard to sex, age, education, and where applicable, length of illness, functional status, and symptom severity. The instruments used to measure memory consisted of the Guild Memory Test, the Memory Span for Objects, the Knox Cube, and the Tactile Memory Test. WAIS Vocabulary scaled score was used as a covariate in an analysis of covariance on each of the nine memory subtests. Statistically significant differences were obtained at the .01 level among groups on all measures. Orthogonal comparisons resulted in significant differences at the .01 level between parkinsonian patients and nonparkinsonian subjects on all measures. Short term and long term L-dopa patients differed significantly on six of the nine measures, notably those testing verbal types of memory. Significant correlations were obtained between functional deficiency and eight measures; however, symptom severity correlated with only one measure. None of the memory measures correlated significantly with level of dosage. The major conclusion was reached that all of the initial improvement shown following L-dopa initiation is not sustained permanently; the elevated level of memory functioning appears to be temporally limited.