Very-Low-Dose Levodopa Therapy for Pediatric Neurological Disorders: A Preliminary Questionnaire in Japan

Frontiers in Pediatrics

article

Kyoko Hoshino¹  Masaharu Hayashi¹  Asayo Ishizaki²  Kazue Kimura¹  Masaya Kubota²  Atsuo Nezu²  Akihiro Yasuhara² 

[1] Segawa Memorial Neurological Clinic for Children;The Very-Low-Dose Levodopa Therapy Research Group http://www.segawa-research.com/ldopa-therapy/index.html;Department of Pediatrics, Minami Wakayama Medical Center;School of Nursing, College of Nursing and Nutrition, Shukutoku University;Oji Clinic, Division of Medicine, The Japanese Association on Intellectual and Developmental Disorders;Division of Neurology, National Center for Child Health and Development;Yokohama Medical and Welfare Centre;Yasuhara Children's Clinic and YCC Education Center

关键词: very low dose levodopa therapy;    autism spectrum disorder;    tics;    tourette syndrome;    attention-deficit/hyperactivity disorder;    dopamine receptor supersensitivity;    Rett syndrome;   

DOI  :  10.3389/fped.2021.569594

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Post-synaptic dopamine receptor supersensitivity (DARSS) has been extensively researched by Dr. Masaya Segawa, who has investigated the efficacy of very-low-dose levodopa therapy (VLDT; 0.5–1 mg/kg/day). Considerable Japanese research supports the possibility that VLDT could be used to treat pediatric neurological disorders. We conducted an on-line survey in 2014 to collect real-world data on the use of VLDT to treat DARSS. Methods: A two-step survey, including a screening test and questionnaire, was posted on a private internet site that could be accessed via the VLDT Research Group home page, and 1,165 pediatric neurologists across Japan were invited to complete it. Results: A total of 25 respondents reported prescribing VLDT; 19 used VLDT to treat autism spectrum disorder, 14 for tics, 12 for speech delay, 9 for Rett syndrome, 7 for attention-deficit/hyperactivity disorder, intellectual disability, and 6 for sleep problems. Twelve respondents reported prescribing a dose of 0.5 mg/kg. Twenty-two reported that VLDT was effective for treating behavioral problems, and twenty reported a good efficacy for treating motor symptoms. Adverse events had a low incidence. Notably, respondents chose VLDT for its possible action in DARSS and for its safety. VLDT was commonly used for behavioral problems in patients younger than 5 years, and for motor symptoms in aged 5–9 years. Conclusion: VLDT could safely treat behavioral and motor symptoms in pediatric neurological disorders. In contrast, dopamine antagonists are associated with potent efficacy, but with adverse effects such as sleepiness and obesity. Further surveys should be conducted with a broader participants.

【 授权许可】

CC BY