Abstract
To investigate whether __Helicobacter pylori (__HP) infection affects the clinical response to levodopa and whether its eradication could improve motor fluctuation in patients with Parkinson's disease (PD). Using the [^13^C] urea breath test, we monitored HP infection in 65 patients with PD and motor fluctuations of the โwearingโoffโ or delayed โonโ types, with or without dyskinesia. We compared the clinical features and response to Lโdopa between HP noninfected (n = 30) and HP infected patients (n = 35) by reviewing home diaries kept for 72 hours. Among HP infected patients, we compared the differences in Lโdopa โonsetโ time, โonโtimeโ duration, and scores on the motor examination section of the Unified PD Rating Scale (UPDRSโIII) during the medication โonโ phase before and after HP eradication. There were no differences in the age, disease duration, Hoehn and Yahr stage, UPDRSโIII score, Lโdopa daily dose, and frequency of dyskinesia between HP noninfected and HP infected groups. However, Lโdopa โonsetโ time was longer and โonโtimeโ duration was shorter in HP infected patients than in HP noninfected patients (78.4 ยฑ 28.2 vs. 56.7 ยฑ 25.1 and 210.0 ยฑ 75.7 vs. 257.7 ยฑ 68.9 min, respectively, P < 0.05). HP eradication improved the delay Lโdopa โonsetโ time and short โonโtimeโ duration (to 58.1 ยฑ 25.6 and to 234.4 ยฑ 66.5 min, respectively, P < 0.05). These data demonstrated that HP infection could interfere with the absorption of Lโdopa and provoke motor fluctuations. HP eradication can improve the motor fluctuations of HP infected patients with PD. ยฉ 2008 Movement Disorder Society