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Intrajejunal levodopa infusion in Parkinson's disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life.
Mov Disord. 2009 Jul 30; 24(10):1468-74.MD

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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Honig H
Department of Neurology, Central Hospital, Bremerhaven, Germany.
Antonini A
No affiliation info available
Martinez-Martin P
No affiliation info available
Forgacs I
No affiliation info available
Faye GC
No affiliation info available
Fox T
No affiliation info available
Fox K
No affiliation info available
Mancini F
No affiliation info available
Canesi M
No affiliation info available
Odin P
No affiliation info available
Chaudhuri KR
No affiliation info available

MeSH

AgedAntiparkinson AgentsDisability EvaluationDuodenumEndoscopes, GastrointestinalFemaleHumansInternational CooperationLevodopaMaleMiddle AgedParkinson DiseasePilot ProjectsProspective StudiesQuality of LifeSeverity of Illness IndexSurveys and QuestionnairesTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

19425079

Citation

Honig, Holger, et al. "Intrajejunal Levodopa Infusion in Parkinson's Disease: a Pilot Multicenter Study of Effects On Nonmotor Symptoms and Quality of Life." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 24, no. 10, 2009, pp. 1468-74.
Honig H, Antonini A, Martinez-Martin P, et al. Intrajejunal levodopa infusion in Parkinson's disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Mov Disord. 2009;24(10):1468-74.
Honig, H., Antonini, A., Martinez-Martin, P., Forgacs, I., Faye, G. C., Fox, T., Fox, K., Mancini, F., Canesi, M., Odin, P., & Chaudhuri, K. R. (2009). Intrajejunal levodopa infusion in Parkinson's disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Movement Disorders : Official Journal of the Movement Disorder Society, 24(10), 1468-74. https://doi.org/10.1002/mds.22596
Honig H, et al. Intrajejunal Levodopa Infusion in Parkinson's Disease: a Pilot Multicenter Study of Effects On Nonmotor Symptoms and Quality of Life. Mov Disord. 2009 Jul 30;24(10):1468-74. PubMed PMID: 19425079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrajejunal levodopa infusion in Parkinson's disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. AU - Honig,Holger, AU - Antonini,Angelo, AU - Martinez-Martin,Pablo, AU - Forgacs,Ian, AU - Faye,Guy C, AU - Fox,Thomas, AU - Fox,Karen, AU - Mancini,Francesca, AU - Canesi,Margherita, AU - Odin,Per, AU - Chaudhuri,K Ray, PY - 2009/5/9/entrez PY - 2009/5/9/pubmed PY - 2009/10/23/medline SP - 1468 EP - 74 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 24 IS - 10 N2 - 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. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/19425079/Intrajejunal_levodopa_infusion_in_Parkinson's_disease:_a_pilot_multicenter_study_of_effects_on_nonmotor_symptoms_and_quality_of_life_ DB - PRIME DP - Unbound Medicine ER -