Clinical and neuropsychological follow up at 12 months in patients with complicated Parkinson's disease treated with subcutaneous apomorphine infusion or deep brain stimulation of the subthalamic nucleus

D. De Gaspari, C. Siri, A. Landi, R. Cilia, A. Bonetti, F. Natuzzi, L. Morgante, C. B. Mariani, E. Sganzerla, G. Pezzoli, Angelo Antonini

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The clinical condition of advanced Parkinson's disease (PD) patients is often complicated by motor fluctuations and dyskinesias which are difficult to control with available oral medications. Objective: To compare clinical and neuropsychological 12 month outcome following subcutaneous apomorphine infusion (APO) and chronic deep brain stimulation of the subthalamic nucleus (STN-DBS) in advanced PD patients. Methods: Patients with advanced PD and medically untreatable fluctuations underwent either APO (13 patients) or STN-DBS (12 patients). All patients were clinically (UPDRS-III, AIMS, 12 h on-off daily) and neuropsychologically (MMSE, Hamilton-17 depression, NPI) evaluated at baseline and at 12 months. APO was discontinued at night. Results: At 12 months APO treatment (74.78 ± 24.42 mg/day) resulted in significant reduction in off time (-51%) and no change in AIMS. Levodopa equivalent medication doses were reduced from 605.98 ± 215 mg/day at baseline to 470 ± 229 mg/day. MMSE, NPI, and Hamilton depression scores were unchanged. At 12 months STN-DBS resulted in significant clinical improvement in terms of reduction in daily off time (-76%) and AIMS (-81%) as well as levodopa equivalent medication doses (980 ± 835 to 374 ± 284 mg/day). Four out of 12 patients had stopped oral medications. MMSE was unchanged (from 28.6 ± 0.3 to 28.4 ± 0.6). Hamilton depression was also unchanged, but NPI showed significant worsening (from 6.58 ± 9.8 to 18.16 ± 10.2; p

Original languageEnglish
Pages (from-to)450-453
Number of pages4
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume77
Issue number4
DOIs
Publication statusPublished - Apr 2006

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Psychiatry and Mental health

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