Which symptom is most likely to improve with carbidopa-levodopa therapy in Parkinson disease?

Which symptom is most likely to improve with carbidopa-levodopa therapy in Parkinson disease?

• A. Tremor
• B. Paresthesias
• C. Hyperglycemia
• D. Headache

Answer: (A)

Parkinson disease motor symptoms arise from a dopamine deficit in the nigrostriatal pathways. Carbidopa-levodopa provides dopamine to the brain, with carbidopa blocking peripheral breakdown so more levodopa reaches the brain. This dopaminergic replacement especially helps resting tremor, a hallmark motor symptom driven by this deficit, so tremor is the symptom most likely to improve with therapy. Paresthesias are sensory, not primarily due to dopamine loss, and hyperglycemia or headaches are not typical motor symptoms of Parkinson’s that respond to dopaminergic treatment.

Parkinson disease motor symptoms arise from a dopamine deficit in the nigrostriatal pathways. Carbidopa-levodopa provides dopamine to the brain, with carbidopa blocking peripheral breakdown so more levodopa reaches the brain. This dopaminergic replacement especially helps resting tremor, a hallmark motor symptom driven by this deficit, so tremor is the symptom most likely to improve with therapy. Paresthesias are sensory, not primarily due to dopamine loss, and hyperglycemia or headaches are not typical motor symptoms of Parkinson’s that respond to dopaminergic treatment.