Improvement of dyskinesias with l‐dopa infusion in advanced Parkinson's disease. (11th September 2015)

• Record Type: Journal Article
• Authors: Timpka, J.; Fox, T.; Fox, K.; Honig, H.; Odin, P.; Martinez‐Martin, P.; Antonini, A.; Ray Chaudhuri, K.
• Is Part Of: Acta neurologica Scandinavica. Volume 133:Number 6(2016:Jun.)
• Page Start: 451
• Page End: 458
• Publication Date: 2015-09-11
• Subjects: continuous dopaminergic stimulation -- dyskinesias -- levodopa–carbidopa intestinal gel -- motor complications -- movement disorders -- Parkinson's disease -- quality of life -- treatment; Neurology -- Periodicals; 616.8
• DOI: 10.1111/ane.12483
• Languages: English
• ISSNs: 0001-6314

Abstract

Abstract : Objectives: We wanted to investigate whether continuous intrajejunal levodopa–carbidopa intestinal gel (LCIG) therapy has an antidyskinetic effect in patients with Parkinson's disease (PD) and troublesome dyskinesias. We also sought to examine the effect of LCIG therapy on motor function and health‐related quality of life (HRQoL). Materials and methods: This open‐label pilot study used a single group pre–post design with follow‐up at 6 months. Nine patients with PD who reported to spend at least 3 h per day in on with troublesome dyskinesia were included. The patients were examined at baseline using clinical and self‐assessment measures and then switched from peroral/transdermal pharmacotherapy to LCIG therapy. Data collection was repeated 6 months after the pharmaceutical intervention. Nonparametric statistical methods were used for data analyses. Results: The mean time spent in on with troublesome dyskinesia per day after 6 months of LCIG therapy decreased by 47% ( P < 0.05). This observation was paralleled by a 112% increase in mean time spent in on without troublesome dyskinesia ( P < 0.01). Patient self‐assessment of dyskinesia intensity on the visual analog scale displayed a 90% reduction of mean dyskinesia intensity ( P < 0.01) and patients also exhibited less dyskinesia during standardized levodopa tests. Furthermore, we noted improvements in motor function and HRQoL. Conclusions: In this pilot study, we found indications that LCIG therapy has a substantial antidyskinetic effect and could be an alternative also for PD patients with dyskinesias as a major symptom. However, further studies with blinded evaluation and larger numbers of patients are warranted to confirm the findings.