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A 5-year prospective assessment of advanced Parkinson disease patients treated with subcutaneous apomorphine infusion or deep brain stimulation.
J Neurol. 2011 Apr; 258(4):579-85.JN

Abstract

Prospective comparative long-term data on the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and continuous subcutaneous infusion of apomorphine (CSAI) in patients with advanced Parkinson disease (PD) are lacking. We report 5-year follow-up of 25 PD patients treated with either STN-DBS (n = 13) or CSAI (n = 12) who fulfilled CAPSIT-PD criteria. Cohorts were matched for disease duration and severity of motor complications. Baseline clinical and neuropsychological status did not differ among cohorts. Patients were assessed with the UPDRS, MMSE, HAMD-17 and Neuropsychiatric Inventory (NPI).Twelve subjects reached the 5-year follow-up with STN-DBS (one was lost at follow-up) versus two in the CSAI cohort. Drop-outs with CSAI were due to subcutaneous nodules (n = 2), insufficient control of motor fluctuations and dyskinesia (n = 4), death for unrelated reasons (n = 3) and one was lost at follow-up. Average apomorphine dose at last visit was 83.4 ± 19.2 mg/day and average treatment duration was 30 months. At 1-year as well as at last follow-up (intention-to-treat analysis), both therapies decreased daily off-time but only STN-DBS reduced dyskinesia duration and severity. Decrement of medications was greater with STN-DBS. There was a significant worsening of NPI after STN-DBS, primarily because four subjects developed apathy.

Authors+Show Affiliations

Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20972684

Citation

Antonini, Angelo, et al. "A 5-year Prospective Assessment of Advanced Parkinson Disease Patients Treated With Subcutaneous Apomorphine Infusion or Deep Brain Stimulation." Journal of Neurology, vol. 258, no. 4, 2011, pp. 579-85.
Antonini A, Isaias IU, Rodolfi G, et al. A 5-year prospective assessment of advanced Parkinson disease patients treated with subcutaneous apomorphine infusion or deep brain stimulation. J Neurol. 2011;258(4):579-85.
Antonini, A., Isaias, I. U., Rodolfi, G., Landi, A., Natuzzi, F., Siri, C., & Pezzoli, G. (2011). A 5-year prospective assessment of advanced Parkinson disease patients treated with subcutaneous apomorphine infusion or deep brain stimulation. Journal of Neurology, 258(4), 579-85. https://doi.org/10.1007/s00415-010-5793-z
Antonini A, et al. A 5-year Prospective Assessment of Advanced Parkinson Disease Patients Treated With Subcutaneous Apomorphine Infusion or Deep Brain Stimulation. J Neurol. 2011;258(4):579-85. PubMed PMID: 20972684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 5-year prospective assessment of advanced Parkinson disease patients treated with subcutaneous apomorphine infusion or deep brain stimulation. AU - Antonini,Angelo, AU - Isaias,Ioannis U, AU - Rodolfi,Giorgia, AU - Landi,Andrea, AU - Natuzzi,Francesca, AU - Siri,Chiara, AU - Pezzoli,Gianni, Y1 - 2010/10/23/ PY - 2010/08/17/received PY - 2010/10/05/accepted PY - 2010/10/04/revised PY - 2010/10/26/entrez PY - 2010/10/26/pubmed PY - 2011/7/20/medline SP - 579 EP - 85 JF - Journal of neurology JO - J Neurol VL - 258 IS - 4 N2 - Prospective comparative long-term data on the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and continuous subcutaneous infusion of apomorphine (CSAI) in patients with advanced Parkinson disease (PD) are lacking. We report 5-year follow-up of 25 PD patients treated with either STN-DBS (n = 13) or CSAI (n = 12) who fulfilled CAPSIT-PD criteria. Cohorts were matched for disease duration and severity of motor complications. Baseline clinical and neuropsychological status did not differ among cohorts. Patients were assessed with the UPDRS, MMSE, HAMD-17 and Neuropsychiatric Inventory (NPI).Twelve subjects reached the 5-year follow-up with STN-DBS (one was lost at follow-up) versus two in the CSAI cohort. Drop-outs with CSAI were due to subcutaneous nodules (n = 2), insufficient control of motor fluctuations and dyskinesia (n = 4), death for unrelated reasons (n = 3) and one was lost at follow-up. Average apomorphine dose at last visit was 83.4 ± 19.2 mg/day and average treatment duration was 30 months. At 1-year as well as at last follow-up (intention-to-treat analysis), both therapies decreased daily off-time but only STN-DBS reduced dyskinesia duration and severity. Decrement of medications was greater with STN-DBS. There was a significant worsening of NPI after STN-DBS, primarily because four subjects developed apathy. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/20972684/A_5_year_prospective_assessment_of_advanced_Parkinson_disease_patients_treated_with_subcutaneous_apomorphine_infusion_or_deep_brain_stimulation_ L2 - https://dx.doi.org/10.1007/s00415-010-5793-z DB - PRIME DP - Unbound Medicine ER -