Intrajejunal levodopa infusion in Parkinson's disease: A pilot multicenter study of effects on nonmotor symptoms and quality of life
Identifieur interne : 002246 ( Main/Exploration ); précédent : 002245; suivant : 002247Intrajejunal levodopa infusion in Parkinson's disease: A pilot multicenter study of effects on nonmotor symptoms and quality of life
Auteurs : Holger Honig [Allemagne] ; Angelo Antonini [Italie] ; Pablo Martinez-Martin [Espagne] ; Ian Forgacs [Royaume-Uni] ; Guy C. Faye [Royaume-Uni] ; Thomas Fox [Allemagne] ; Karen Fox [Allemagne] ; Francesca Mancini [Italie] ; Margherita Canesi [Italie] ; Per Odin [Allemagne] ; K. Ray Chaudhuri [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-07-30.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (administration & dosage), Disability Evaluation, Duodenum, Duodenum (drug effects), Duodenum (physiology), Endoscopes, Gastrointestinal, Female, Humans, International Cooperation, Levodopa, Levodopa (administration & dosage), Male, Middle Aged, Multicenter study, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (psychology), Parkinson disease, Parkinson's disease, Pilot Projects, Prospective Studies, Quality of Life (psychology), Quality of life, Questionnaires, Severity of Illness Index, Treatment Outcome, duodenum, infusion, nonmotor, quality of life.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- drug effects : Duodenum.
- drug therapy : Parkinson Disease.
- physiology : Duodenum.
- physiopathology : Parkinson Disease.
- psychology : Parkinson Disease, Quality of Life.
- Aged, Disability Evaluation, Endoscopes, Gastrointestinal, Female, Humans, International Cooperation, Male, Middle Aged, Pilot Projects, Prospective Studies, Questionnaires, Severity of Illness Index, Treatment Outcome.
Abstract
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
Url:
DOI: 10.1002/mds.22596
Affiliations:
- Allemagne, Espagne, Italie, Royaume-Uni
- Angleterre, Communauté de Madrid, Grand Londres, Lombardie
- Londres, Madrid, Milan
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Le document en format XML
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<term>Duodenum (drug effects)</term>
<term>Duodenum (physiology)</term>
<term>Endoscopes, Gastrointestinal</term>
<term>Female</term>
<term>Humans</term>
<term>International Cooperation</term>
<term>Levodopa</term>
<term>Levodopa (administration & dosage)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Multicenter study</term>
<term>Nervous system diseases</term>
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<front><div type="abstract" xml:lang="en">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</div>
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