title: Levodopa/carbidopa intestinal gel can improve both motor and non-motor experiences of daily living in Parkinson's disease: An open-label study.
abstract: Levodopa/carbidopa intestinal gel therapy (LCIG) can efficiently improve several motor and non-motor symptoms of advanced Parkinson's disease (PD). The recently developed Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) improved the original UPDRS making it a more robust tool to evaluate therapeutic changes. However, previous studies have not used the MDS-UPDRS and the Unified Dyskinesia Rating Scale (UDysRS) to assess the efficacy of LCIG.
  
  
  
  Our aim was to determine if the MDS-UPDRS and UDysRS could detect improvement in the experiences of daily living following 1-year LCIG treatment.
  
  
  
  In this prospective, multicenter, open-label study, 34 consecutive patients undergoing LCIG treatment were enrolled. Patients were examined twice: prior to LCIG initiation and 12 months later. Impact of PD-related symptoms and dyskinesia was assessed by the MDS-UPDRS and UDysRS.
  
  
  
  Non-motor Experiences of Daily Living part of MDS-UPDRS improved from 20 (median, interquartile-range, IQR:14-23) to 16 points (median, IQR:12-20, p = 0.044) and the Motor Experiences of Daily Living ameliorated from 24 (median, IQR:20-29) to 18 points (median, IQR:13-25, p = 0.025). Health-related quality of life, measured by PDQ-39, also improved from 35.4 (median, IQR:26.9-50.3) to 27.0 (median, IQR:21.3-31.4) points (p = 0.003). The total score of UDysRS decreased from 47 (median, IQR:36-54) to 34 (median, IQR:21-45) points (p = 0.003).
  
  
  
  As far as the authors are aware of, our paper is the first to evaluate the impact of LCIG on dyskinesia by the means of UDysRS. Changes in MDS-UPDRS and UDysRS confirm that LCIG treatment can efficiently improve experiences of daily living in advanced PD.
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Annamária
authors.initials: A
authors.lastname: Juhász
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Aschermann
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Ács
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroimaging MR Research Group, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Márton
authors.initials: M
authors.lastname: Kovács
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Makkos
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Márk
authors.initials: M
authors.lastname: Harmat
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Dalma
authors.initials: D
authors.lastname: Tényi
authors.affiliation: Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary.
authors.forename: Kázmér
authors.initials: K
authors.lastname: Karádi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Sámuel
authors.initials: S
authors.lastname: Komoly
authors.affiliation: Department of Neurology, Semmelweis University, Budapest, Hungary.
authors.forename: Annamária
authors.initials: A
authors.lastname: Takáts
authors.affiliation: Department of Neurology, Semmelweis University, Budapest, Hungary.
authors.forename: Adrián
authors.initials: A
authors.lastname: Tóth
authors.affiliation: Department of Neurology, Semmelweis University, Budapest, Hungary.
authors.forename: Helga
authors.initials: H
authors.lastname: Nagy
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Klivényi
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Dibó
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary.
authors.forename: Lívia
authors.initials: L
authors.lastname: Dézsi
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary.
authors.forename: Dénes
authors.initials: D
authors.lastname: Zádori
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary.
authors.forename: Ádám
authors.initials: Á
authors.lastname: Annus
authors.affiliation: Department of Neurology, University of Szeged, Szeged, Hungary; MTA-SZTE Neuroscience Research Group, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Vécsei
authors.affiliation: Borsod-Abaúj-Zemplén County Hospital, Miskolc, Hungary.
authors.forename: Lajos
authors.initials: L
authors.lastname: Varannai
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroimaging MR Research Group, Pécs, Hungary. Electronic address: kovacsnorbert06@gmail.com.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kovács
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D002230:Carbidopa / Q000627:therapeutic use*; D004185:Disability Evaluation; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D007422:Intestines / Q000502:physiology*; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D005782:Gels; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa
keywords: Disability; Duodopa; Dyskinesia; Enteral infusion; Parkinson's disease