15 June 2007
Antonini
A, Isaias IU, Canesi M, Zibetti M, Mancini F, Manfredi L, Dal Fante M, Lopiano
L, Pezzoli G
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.
