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Duodenal levodopa infusion improves quality of life in advanced Parkinson's disease

Neurodegenerative Diseases, ISSN: 1660-2854, Vol: 5, Issue: 3-4, Page: 244-246
2008
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Conference Paper Description

Background: A significant percentage of patients with Parkinson's disease (PD) continue to experience motor fluctuations and dyskinesias despite the association of dopamine agonists and levodopa with COMT or MAO-B inhibitors. The use of apomorphine infusion is limited by compliance while deep brain stimulation is feasible only for a small number of patients mostly because of age constraints. Objective: To assess prospectively the effectiveness of duodenal levodopa infusion on quality of life as well as motor features in patients with advanced PD. In all but 1 case levodopa infusion was stopped at nighttime. Methods: We report the outcome of 22 PD patients, followed for up to 2 years, who were on continuous duodenal levodopa/carbidopa infusion through percutaneous endoscopic gastrostomy. Results: We found a significant reduction in 'off' period duration as well as dyskinesia severity (Unified Parkinson's Disease Rating Scale part IV, items 33 and 39). There was significant improvement in the 39-item Parkinson's Disease Quality of Life Questionnaire as well as in the Unified Parkinson's Disease Rating Scale part II up to the 2-year follow-up. Five patients withdrew: 2 for poor compliance and 3 for adverse events (1 was related to percutaneous endoscopic gastrostomy). Conclusions: These results demonstrate significant clinical improvements in quality of life and activities of daily living consistent with the occurrence of a satisfactory therapeutic response and a reduction in dyskinesia severity. Copyright © 2008 S. Karger AG.

Bibliographic Details

A. Antonini; M. Canesi; I. U. Isaias; F. Natuzzi; G. Pezzoli; F. Mancini; L. Manfredi; R. Zangaglia; C. Pacchetti; G. Nappi; M. Zibetti; L. Lopiano

S. Karger AG

Neuroscience; Medicine

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