Intrajejunal levodopa infusion in Parkinson's disease: A pilot multicenter study of effects on nonmotor symptoms and quality of life

Movement Disorders - Tập 24 Số 10 - Trang 1468-1474 - 2009
Holger Honig1, Angelo Antonini2, Pablo Martínez‐Martín3, I Forgács4, Guy C. Faye4, Thomas Peter Fox1, Karen M. Fox1, Francesca Mancini2, Margherita Canesi2, Per Odin1, К. Ray Chaudhuri4
1Department of Neurology, Central Hospital, Bremerhaven, Germany
2Parkinson Institute, ICP, Hospital San Pio X, Milan, Italy
3Area of Applied Epidemiology, National Center for Epidemiology, and CIBERNED, Carlos III Institute of Health, Madrid, Spain
4National Parkinson Foundation Centre of Excellence, King's College and Institute of Psychiatry, London, United Kingdom

Tóm tắt

AbstractSwitching from oral medications to continuous infusion of levodopa/carbidopa gel reduces motor complications in advanced Parkinson's disease (PD), but effects on nonmotor symptoms (NMSs) are unknown. In this prospective open‐label observational study, we report the effects of intrajejunal levodopa/carbidopa gel infusion on NMS in PD based on standard assessments utilizing the nonmotor symptoms scale (NMSS) along with the unified Parkinson's disease rating scale (UPDRS 3 motor and 4 complications) and quality of life (QoL) using the Parkinson's disease questionnaire (PDQ‐8). Twenty‐two advanced PD patients (mean age 58.6 years, duration of disease 15.3 years) were followed for 6 months. A statistically significant beneficial effect was shown in six of the nine domains of the NMSS: cardiovascular, sleep/fatigue, attention/memory, gastrointestinal, urinary, and miscellaneous (including pain and dribbling) and for the total score of this scale (NMSST) paralleling improvement of motor symptoms (UPDRS 3 motor and 4 complications in “best on” state) and dyskinesias/motor fluctuations. In addition, significant improvements were found using the Parkinson's disease sleep scale (PDSS) and the PDQ‐8 (QoL). The improvement in PDQ‐8 scores correlated highly significantly with the changes in NMSST, whereas a moderately strong correlation was observed with UPDRS changes. This is the first demonstration that a levodopa‐based continuous dopaminergic stimulation is beneficial for NMS and health‐related quality of life in PD in addition to the reduction of motor fluctuations and dyskinesias. © 2009 Movement Disorder Society

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Movement Disorders

Tập 24 Số 10

1468-1474

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