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

Switching 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 levod...

Full description

Saved in:
Bibliographic Details
Published in:Movement disorders 2009-07, Vol.24 (10), p.1468-1474
Main Authors: Honig, Holger, Antonini, Angelo, Martinez-Martin, Pablo, Forgacs, Ian, Faye, Guy C., Fox, Thomas, Fox, Karen, Mancini, Francesca, Canesi, Margherita, Odin, Per, Chaudhuri, K. Ray
Format: Article
Language:English
Subjects:
Aged
Antiparkinson Agents - administration & dosage
Biological and medical sciences
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Disability Evaluation
duodenum
Duodenum - drug effects
Duodenum - physiology
Endoscopes, Gastrointestinal
Female
Humans
infusion
International Cooperation
Levodopa - administration & dosage
Male
Medical sciences
Middle Aged
Neurology
nonmotor
Parkinson Disease - drug therapy
Parkinson Disease - physiopathology
Parkinson Disease - psychology
Parkinson's disease
Pilot Projects
Prospective Studies
quality of life
Quality of Life - psychology
Severity of Illness Index
Surveys and Questionnaires
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Switching 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
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.22596