Intrajejunal levodopa infusion in Parkinson's disease: A pilot multicenter study of effects on nonmotor symptoms and quality of life

Holger Honig, Angelo Antonini, Pablo Martinez-Martin, Ian Forgacs, Guy C. Faye, Thomas Fox, Karen Fox, Francesca Mancini, Margherita Canesi, Per Odin, K. Ray Chaudhuri

Research output: Contribution to journalArticle

Abstract

Switching from oral medications to continuous infusion of levodopa/ carbidopa gel reduces motor complications in advanced Parkinson's disease (PD), but effects on nonmotor symptoms (NMSs) are unknown. In this prospective open-label observational study, we report the effects of intrajejunal levodopa/carbidopa gel infusion on NMS in PD based on standard assessments utilizing the nonmotor symptoms scale (NMSS) along with the unified Parkinson's disease rating scale (UPDRS 3 motor and 4 complications) and quality of life (QoL) using the Parkinson's disease questionnaire (PDQ-8). Twenty-two advanced PD patients (mean age 58.6 years, duration of disease 15.3 years) were followed for 6 months. A statistically significant beneficial effect was shown in six of the nine domains of the NMSS: cardiovascular, sleep/fatigue, attention/memory, gastrointestinal, urinary, and miscellaneous (including pain and dribbling) and for the total score of this scale (NMSST) paralleling improvement of motor symptoms (UPDRS 3 motor and 4 complications in "best on" state) and dyskinesias/motor fluctuations. In addition, significant improvements were found using the Parkinson's disease sleep scale (PDSS) and the PDQ-8 (QoL). The improvement in PDQ-8 scores correlated highly significantly with the changes in NMSST, whereas a moderately strong correlation was observed with UPDRS changes. This is the first demonstration that a levodopa-based continuous dopaminergic stimulation is beneficial for NMS and health-related quality of life in PD in addition to the reduction of motor fluctuations and dyskinesias.

Original languageEnglish
Pages (from-to)1468-1474
Number of pages7
JournalMovement Disorders
Volume24
Issue number10
DOIs
Publication statusPublished - Jul 30 2009

Keywords

  • Duodenum
  • Infusion
  • Nonmotor
  • Parkinson's disease
  • Quality of life

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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