title: Levodopa infusion improves impulsivity and dopamine dysregulation syndrome in Parkinson's disease.
abstract: BACKGROUND
  Impulsivity and dopamine dysregulation syndrome are frequent complications of treatment in Parkinson's disease (PD).
  
  
  METHODS
  We assessed the effect of jejunal levodopa infusion (JLI) on behavioral symptoms in 8 PD patients with motor complications and severe impulsivity and dopamine dysregulation syndrome (DDS), which had not be controlled before by adjusting oral medications. The infusion was delivered during 15 hours (daily dose 1007.2 ± 302.5 mg) and stopped at night time. Patients were reassessed after 25 ± 9 weeks of treatment with a stable dose of jejunal l-dopa.
  
  
  RESULTS
  Off periods and dyskinesias decreased by 27% and 20,7% respectively, compared to baseline. DDS and all types of impulse control disorders (ICDs) improved in all patients, with nearly complete symptom resolution. Punding improved in all 5 patients but disappeared completely in only 1.
  
  
  CONCLUSIONS
  Our experience suggests that l-dopa infusion has a positive effect on both motor complications and behavioral disorders. This treatment approach deserves further controlled studies.
authors.affiliation: Movement Disorders Unit, Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Catalán
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Pablo-Fernández
authors.forename: Clara
authors.initials: C
authors.lastname: Villanueva
authors.forename: Servando
authors.initials: S
authors.lastname: Fernández-Diez
authors.forename: Teresa
authors.initials: T
authors.lastname: Lapeña-Montero
authors.forename: Rocío
authors.initials: R
authors.lastname: García-Ramos
authors.forename: Eva
authors.initials: E
authors.lastname: López-Valdés
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000188:drug therapy* / Q000209:etiology*; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa; D004298:Dopamine
keywords: DDS; Parkinson's disease; impulse control disorders; infusion pumps; intraduodenal levodopa; levodopa, administration and dosage