Efficacy of Transdermal Nicotine, on Motor Symptoms in Advanced Parkinson's Disease

Exclusion Criteria

• •Previous neurosurgery for Parkinson's disease,
• •Weight \< 45 kg or \> 100 kg,
• •Previous Parkinson's disease treatment by transdermal nicotine-therapy discontinued less than 6 months before inclusion,
• •History of allergy to Nicotine,
• •History of allergy to transdermal device,
• •Cutaneous disorders wich could disturb use of transdermal device,
• •Cognitive disorders, (Mattis score \< 125)
• •History or detection at inclusion of cardiac arrhythmia,
• •History of coronary failure,
• •History of cardiac failure, (NYHA from II to IV \& ejection fraction (EF) \< 40%)
• •Severe arterial hypertension (diastolic \> 100 mmHg) or uncontrolled,
• •Symptomatic orthostatic hypotension, (2 points of differential in standing position and systolic \<100mm Hg or clinical evidence)
• •History of stroke or occlusive peripheral vascular disease,
• •History of hyperthyroid,
• •History or detection at inclusion of type I or II diabetes, (HbA1c \< 11%)
• •History of pulmonary disease: asthma, chronic obstructive pulmonary disease (COPD),
• •History of auto-immune disease,
• •Progressive depression, suicide attack, acute psychosis, invasive hallucinations, psychiatrist opinion harmful for a correct compliance to experimentation,
• •History or recent gastroduodenal ulcer, (\< 3 months)
• •History or detection at inclusion of hepatobiliary or renal failure, (clearance\< 60 mL/min)
• •Pregnancy, breast-feeding,
• •Absence of effective contraception in women in childbearing potential,
• •Treatment by nifedipine, beta-blockers, diuretics, insulin and H2 antihistaminics for potential side effects in combination with nicotine,
• •Patients unlikely to be compliant or to fully cooperate during the study.