L-dopa

L-dopa

L-dopa (Levodopa) is an inexpensive drug that has been widely used to treat Parkinson’s disease.1 It is commonly used to help relieve symptoms such as shaking and slow movements. Levodopa is able to pass from the blood into the brain via the blood-brain barrier – unlike dopamine, which cannot cross this barrier. Once in the brain, scientists believe it changes into dopamine. Dopamine is important because it is a neurotransmitter. In other words, it is a substance that helps to send messages within the brain. Professor Bipin Bhakta at the University of Leeds is leading an extensive study2 to investigate whether this drug can also help stroke survivors to relearn activities, such as walking and caring for themselves.3

  • Possible benefits of L-dopa for stroke

    There is a good deal of excitement about the first major study into the effects of L-dopa for stroke, published in 2009. As Professor Bhakta explains:

    ‘If an existing and inexpensive drug can help augment the effects of conventional rehabilitation treatments this represents a major step forward in improving stroke recovery.’

    There is evidence that L-dopa can enhance some of the pathways within the brain. In particular, it might boost your ability to learn, which could help to restore movement after a stroke. Researchers at the University of Leeds hope that stroke survivors will be able to increase their mobility when they combine physiotherapy and occupational therapy with L-dopa. They explain:

    ‘Recovery from stroke is essentially an educational process – rehabilitation assists the person to relearn skills. We want to find out if using an existing drug in a new context enhances this learning, offering the potential for speedier recovery for many people with stroke.’5

    In 2009, the results of an Italian pilot study appeared in Restorative Neurology and Neuroscience. Researchers treated five stroke survivors with L-dopa and five others with a dummy substance, or placebo. All participants stopped physiotherapy during the trial and underwent a series of tests to measure improvements in abilities such as dexterity and walking. The team found:

    ‘After L-DOPA treatment patients improved their walking speed (p< 0.01) and manual dexterity (p< 0.01) with the affected hand … while no changes were found in placebo-group.

    Conclusion: A 5-week course of oral L-DOPA in a single daily dose substantially improves motor performance in patients with chronic stroke…’6

  • Arguments against using L-dopa for stroke

    L-dopa does not work for everyone when used for Parkinson’s disease. Many people who use the drug experience a number of side effects. According to the Columbia Encyclopedia,

    ‘… virtually all patients on l-dopa experience side effects including nausea, loss of appetite, cardiac irregularities, and psychological change.7

    We must also remember that extensive research into this treatment only began in 2009. We will have to wait for the results of the larger study before we can be sure of the effects of L-dopa on stroke recovery.

  • Notes and references
    1. L-dopa is also known as: Levodopa, Bendopa, Brocadopa, Larodopa.
    2. Researchers at the University of Leeds are continuing their research in a clinical trial that began in 2010. Results from the trial will be published in autumn 2016. DARS trial
    3. ‘New step forward for stroke patients‘. University of Leeds: Published Thursday 15th October 09
    4. ‘New step forward for stroke patients‘. University of Leeds: Published Thursday 15th October 09
    5. ‘New step forward for stroke patients‘. University of Leeds: Published Thursday 15th October 09
    6. Researchers also reported the following:

      ‘Patients underwent clinical evaluation (Rivermead Motor Assessment, Nine Hole Peg Test, and 10 meter walking test) and transcranial magnetic stimulation recordings from the affected and unaffected hemisphere (resting motor threshold, motor evoked potential amplitude and cortical silent period) before and after 5 weeks of treatment.’ (‘Long-term Levodopa administration in chronic stroke patients. A clinical and neurophysiologic single-blind placebo-controlled cross-over pilot study’ by M. Acler. A. Fiasch, P. Manganotti. In Restorative Neurology and Neuroscience, Volume 27, Number 4(2009) 277-283)

    7. Columbia Encyclopaedia Sixth Edition

Aviva Cohen is the author and CEO of Neuro Hero