Duodenal levodopa infusion for advanced Parkinson's disease: 12-month treatment outcome

被引:192
作者
Antonini, Angelo
Isaias, Ioannis U.
Canesi, Margherita
Zibetti, Maurizio
Mancini, Francesca
Manfredi, Luigi
Dal Fante, Marco
Lopiano, Leonardo
Pezzoli, Gianni
机构
[1] Inst Clinici Perfezionamento, Parkinson Inst, I-20126 Milan, Italy
[2] Univ Milano Bicocca, Dept Neurosci, Milan, Italy
[3] Univ Turin, Dept Neurosci, Turin, Italy
[4] Hosp San Pio X, Dept Neurol & Gastroenterol, Milan, Italy
关键词
Parkinson's disease; levodopa; carbidopa; duodenal administration; continuous infusion; motor complications;
D O I
10.1002/mds.21500
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We assessed prospectively clinical and quality of life changes in 9 patients with Parkinson's disease (PD; H&Y >= 3) with severe motor fluctuations and dyskinesia who started continuous daily levodopa duodenal infusion through percutaneous endoscopic gastrostomy. Seven patients completed the follow-up period. Duration of "off" periods and time with disabling dyskinesia shortened significantly in all patients (P < 0.01). Total daily dose of levodopa infused did not differ from baseline equivalents. There were significant improvements in UPDRS-II (activities of daily living) and -IV (motor complications) in the "on" condition (P < 0.02), and in four PDQ-39 domains (mobility, activities of daily living, stigma, bodily discomfort; P < 0.05). Two patients withdrew for adverse events. Our results demonstrate that a satisfactory therapeutic window can be achieved and maintained for several months in advanced PD patients. (c) 2007 Movement Disorder Society.
引用
收藏
页码:1145 / 1149
页数:5
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