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The timing of continuous dopaminergic stimulation (CDS) treatment is an important consideration for achieving optimal motor functioning in Parkinson’s disease patients. Delaying treatment with levodopa/carbidopa intestinal gel (LCIG) infusion in patients with severe ‘on-off’ fluctuations may result in a poorer and slower response, while early initiation of CDS therapy increases the chance of achieving continuous ‘on’ without dyskinesia. Furthermore, overnight LCIG infusion is indicated when there is severe akinesia overnight, but daytime-only LCIG infusion treatment can lead to a reduction in overnight motor fluctuations after several months.

The Timing of Continuous Dopaminergic Stimulation for Optimal Clinical Outcomes