Premium
Long‐term effect of levodopa‐carbidopa intestinal gel on axial signs in Parkinson’s disease
Author(s) -
Fabbri Margherita,
Pongmala Chatkaew,
Artusi Carlo Alberto,
Romagnolo Alberto,
Rizzone Mario Giorgio,
Zibetti Maurizio,
Lopiano Leonardo
Publication year - 2019
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13110
Subject(s) - levodopa , carbidopa , parkinson's disease , rating scale , medicine , disease , physical therapy , psychology , developmental psychology
Background Few studies have suggested that levodopa‐carbidopa intestinal gel (LCIG) may have a benefit on Parkinson's disease (PD) axial signs. Aims of the study To investigate the long‐term effect of LCIG on axial signs and the related prognostic factors. Methods A retrospective study on 49 PD patients treated with LCIG. Axial signs as per the Unified Parkinson Disease Rating Scale axial score (AS), Hoehn and Yahr (H&Y) scale, and levodopa equivalent daily dose (LEDD) were assessed at baseline (before starting LCIG treatment) and at the last follow‐up (FU). Results After 47.6 ± 30 months of treatment, total AS deteriorated while motor complications still improved, in spite of a significant LEDD/Kg increment. When adjusted for LCIG treatment duration, a higher AS and freezing of gait severity at FU were predicted by a baseline lower response to l ‐dopa and higher H&Y ( P < 0.01) and they were related to a lower independency in activity of daily life at FU ( P < 0.001). Single axial items remain stable up to one year and postural instability up to four years. Conclusion Baseline disease severity and the magnitude of l ‐dopa response predict axial signs’ severity after around four years of LCIG treatment, with consequent implication on patients’ functional independence.