Duodenal levodopa infusion for advanced Parkinson's disease: 12-month treatment outcome

✍ Scribed by Angelo Antonini; Ioannis U. Isaias; Margherita Canesi; Maurizio Zibetti; Francesca Mancini; Luigi Manfredi; Marco Dal Fante; Leonardo Lopiano; Gianni Pezzoli

• Book ID: 102507786
• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 112 KB
• Volume: 22
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.21500

✦ Synopsis

Abstract

We assessed prospectively clinical and quality of life changes in 9 patients with Parkinson's disease (PD; H&Y ≥ 3) with severe motor fluctuations and dyskinesia who started continuous daily levodopa duodenal infusion through percutaneous endoscopic gastrostomy. Seven patients completed the follow‐up period. Duration of “off” periods and time with disabling dyskinesia shortened significantly in all patients (P < 0.01). Total daily dose of levodopa infused did not differ from baseline equivalents. There were significant improvements in UPDRS‐II (activities of daily living) and ‐IV (motor complications) in the “on” condition (P < 0.02), and in four PDQ‐39 domains (mobility, activities of daily living, stigma, bodily discomfort; P < 0.05). Two patients withdrew for adverse events. Our results demonstrate that a satisfactory therapeutic window can be achieved and maintained for several months in advanced PD patients. © 2007 Movement Disorder Society