title: Long-term duodenal levodopa infusion in Parkinson's disease: a 3-year motor and cognitive follow-up study.
abstract: Duodenal infusion of levodopa/carbidopa gel (Duodopa) is an effective treatment option for advanced Parkinson's disease (PD). Long-term clinical experience up to 16 years suggests that the safety of this procedure is acceptable, while several observational studies showed that Duodopa reduces motor fluctuations and dyskinesias improving patients' quality of life (QoL). The aim of this study is to investigate the long-term motor and cognitive outcome of Duodopa treatment in advanced PD patients and its' impact on the QoL. Twenty-five consecutive PD patients were assessed using the Unified PD rating scale (UPDRS), a battery of neuropsychological tests, and the PD questionnaire (PDQ-39) at baseline and after a mean period of three years of Duodopa treatment. Seventeen out of 25 patients reached the follow-up evaluation; five patients discontinued Duodopa and three patients died of causes unrelated to drug infusion. Duodopa improved motor complications (UPDRS-IV) and quality of life (PDQ-39). A sub-group of subjects (41 %) developed a significant deterioration of cognitive functions over time. The most common adverse events were dislocation and the kinking of the intestinal tube. In conclusion, Duodopa therapy is effective in the long-term treatment of advanced PD patients. Continuous enteral levodopa infusion achieves a reduction of motor fluctuations and dyskinesias improving patients' QoL, despite the progression of PD motor symptoms and a significant decline in cognitive functions in a sub-group of patients.
authors: Department of Neuroscience, University of Torino, Via Cherasco 15, 10126, Turin, Italy. maurizio.zibetti@gmail.com
authors: Maurizio
authors: M
authors: Zibetti
authors: Aristide
authors: A
authors: Merola
authors: Valeria
authors: V
authors: Ricchi
authors: Alice
authors: A
authors: Marchisio
authors: Carlo Alberto
authors: CA
authors: Artusi
authors: Laura
authors: L
authors: Rizzi
authors: Elisa
authors: E
authors: Montanaro
authors: Dario
authors: D
authors: Reggio
authors: Claudio
authors: C
authors: De Angelis
authors: Mario
authors: M
authors: Rizzone
authors: Leonardo
authors: L
authors: Lopiano
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology; D004185:Disability Evaluation; D004338:Drug Combinations; D004386:Duodenum / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007980:Levodopa / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D018709:Statistics, Nonparametric
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa