title: Treatment of Parkinson's disease could be regulated by movement sensors: subcutaneous infusion of varying apomorphine doses according to the intensity of motor activity.
abstract: Most recent therapeutic solutions to treat Parkinson's disease seek continuous administration of dopaminergic agonists, as for example rigotine patches or apomorphine infusion pumps. Such drug-delivery devices are aimed at preventing fluctuations in drug plasma levels, which could cause certain symptoms such as wearing-off periods or dyskinesia. However, we postulate that drug plasma levels should not keep constant, but rather adjust to the varying intensity of the different user's activities. The rationale behind this is that the drug amount appropriate to treat a patient at rest is lower than that required to treat the same patient when engaged in physical activity. We propose dynamic real-time dose adjustment, so that the doses increase as the patient starts performing physical activity, thus preventing off periods such as "freeze" phenomenon, and the doses reduce during the resting periods, thus preventing adverse effects. Small portable movement sensors are currently available, which detect the amount and type of activity in a continuous way. Combining such technology with infusion pumps to produce modified pumps capable of adjusting the infusion rate to the user's activity, seems to be feasible in the short-term.
authors.affiliation: Clinical Research Unit, Fundació Hospital Comarcal Sant Antoni Abat, Vilanova i la Geltrú, Barcelona, Spain. rodriguez.molinero@gmail.com
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodríguez-Molinero
authors.forename: David A
authors.initials: DA
authors.lastname: Pérez-Martínez
authors.forename: Andreu
authors.initials: A
authors.lastname: Català
authors.forename: Joan
authors.initials: J
authors.lastname: Cabestany
authors.forename: Antonio
authors.initials: A
authors.lastname: Yuste
mesh_terms: D001058:Apomorphine / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous; D008991:Monitoring, Physiologic / Q000379:methods*; D009043:Motor Activity; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D001058:Apomorphine