title: Sleep improvement with levodopa/carbidopa intestinal gel infusion in Parkinson disease.
abstract: BACKGROUND
  Sleep disorders are common in patients with advanced Parkinson's disease (PD). Nocturnal akinesia and sleep fragmentation frequently coexist with daytime sleepiness, influencing daytime functioning. Levodopa/carbidopa intestinal gel (LCIG) infusion has been shown to improve motor complications in advanced PD, and preliminary findings suggest that sleep might improve following LCIG infusion.
  
  
  OBJECTIVE
  To analyze the impact of LCIG infusion on sleep symptoms and daytime sleepiness in patients with PD.
  
  
  METHODS
  Twelve consecutive patients with PD completed the PD-Sleep-Scale-version-2 (PDSS-2) and the Epworth-Sleepiness-Scale (ESS) at baseline and after 2-4 months of LCIG treatment. Activities of daily living, motor symptoms and complications were assessed with the Unified-PD-rating-Scale section II, III, and IV.
  
  
  RESULTS
  Nocturnal sleep improved substantially in all patients switched to LCIG infusion. PDSS-2 total score and subscores for 'Disturbed sleep', 'Motor symptoms at night', and 'PD symptoms at night' were significantly reduced. ESS measures of daytime sleepiness also improved. Motor complications and activities of daily living improved significantly with LCIG.
  
  
  CONCLUSIONS
  Subjective measures of sleep quality and daytime sleepiness improve in patients with advanced PD undergoing LCIG infusion. Further studies with a larger number of patients and polysomnographic recordings are needed to confirm the beneficial effect on sleep and clarify the underlying mechanisms.
authors: Department of Neuroscience, University of Torino, Italy. maurizio.zibetti@gmail.com
authors: M
authors: M
authors: Zibetti
authors: M
authors: M
authors: Rizzone
authors: A
authors: A
authors: Merola
authors: S
authors: S
authors: Angrisano
authors: L
authors: L
authors: Rizzi
authors: E
authors: E
authors: Montanaro
authors: A
authors: A
authors: Cicolin
authors: L
authors: L
authors: Lopiano
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002230:Carbidopa / Q000008:administration & dosage / Q000627:therapeutic use*; D006970:Disorders of Excessive Somnolence / Q000209:etiology / Q000517:prevention & control; D004333:Drug Administration Routes; D004338:Drug Combinations; D004386:Duodenum; D005260:Female; D005774:Gastrostomy; D005782:Gels; D006801:Humans; D015918:Infusion Pumps, Implantable; D007583:Jejunum; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000188:drug therapy / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020919:Sleep Disorders, Intrinsic / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D005782:Gels; D007980:Levodopa; D002230:Carbidopa