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Infection with the gastric ulcer-causing bacterium Helicobacter pylori delays 
the onset of symptomatic benefit from a dose of levodopa, and shortens "on" 
time, according to this study, and both effects can be mitigated with 
antibiotic treatment. These results confirm and extend previous findings on 
the effect of H. pylori on levodopa adsorption ( 
http://www.mdvu.org/emove/article.asp?ID=892 )

Infection status of patients was determined with the [13C] urea breath test, a 
non-invasive diagnostic test. Thirty-five infected and 30 non-infected 
patients were evaluated for time to "on" and duration of "on" via 72-hour 
home diary prior to the screening test. There were no significant differences 
between groups in disease duration, UPDRS motor "on" score, daily levodopa 
dose, or prevalence of peak-dose dyskinesia. Delay to "on" and duration 
of "on" did differ:

                Delay to "on"           Duration of "on"
Infected        78 min                  210 min
Non-infected    56 min                  257 min

Antibiotics successfully eradicated H. pylori in 34 of 35 patients. 
Eradication did not significantly chance motor "on" scores or dyskinesias. It 
did improve both delay to "on" and duration of "on":

                Delay to "on"           Duration of "on"
Pre-treatment   78 min                  210 min
Post-treatment  58 min                  234 min

"These data suggest that HP infection may alter L-dopa absorption and lead to 
motor fluctuations in PD patients," the authors conclude. They note that the 
[13C] urea breath test has high sensitivity and specificity, and has become 
the most convenient way of detecting an active HP infection. Overall 
seropositivity for H. pylori in the elderly has been estimated at over 50%, 
and is often asymptomatic.

Helicobacter pylori infection and motor fluctuations in patients with 
Parkinson's disease
WY Lee, WT Yoon, HY Shin, SH Jeon, PL Rhee
Movement Disorders 2008; epub ahead of print; doi: 10.1002/mds.22190

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