Grazia Devigili1, Sara Rinaldo2, Christian Lettieri2, Roberto Eleopra2. 1. Neurological Unit, Department of Neuroscience, University-Hospital "S. Maria della Misericordia", 33100, Udine, Italy. grazia.devigili@asuiud.sanita.fvg.it. 2. Neurological Unit, Department of Neuroscience, University-Hospital "S. Maria della Misericordia", 33100, Udine, Italy.
Abstract
INTRODUCTION: Peripheral neuropathy related to levodopa/carbidopa intestinal gel (LCIG) therapy for advanced Parkinson disease (PD) is under investigation and is debated in the literature. The purpose of the study was to detect whether small nerve fibers are damaged during LCIG infusion. METHODS: Five advanced PD patients were enrolled prior to starting LCIG infusion. Six PD patients on oral levodopa (LD) treatment and 6 PD patients naïve to LD were also enrolled. Clinical examination, the Quantitative Sensory Testing battery testing, nerve conduction studies, and intraepidermal nerve fiber density examinations were collected at baseline and at 3, 6, and 12 months after LCIG infusion was started in the study cohort. RESULTS: After 3, 6, and 12 months, severe skin denervation and increased thermal thresholds were observed in the LCIG group. CONCLUSIONS: Significant damage to small nerve fibers was detected in PD patients soon after LCIG infusion had started, suggesting careful monitoring of small fiber impairment during LCIG is needed. Muscle Nerve, 2016 Muscle Nerve 54: 970-972, 2016.
INTRODUCTION:Peripheral neuropathy related to levodopa/carbidopa intestinal gel (LCIG) therapy for advanced Parkinson disease (PD) is under investigation and is debated in the literature. The purpose of the study was to detect whether small nerve fibers are damaged during LCIG infusion. METHODS: Five advanced PDpatients were enrolled prior to starting LCIG infusion. Six PDpatients on oral levodopa (LD) treatment and 6 PDpatients naïve to LD were also enrolled. Clinical examination, the Quantitative Sensory Testing battery testing, nerve conduction studies, and intraepidermal nerve fiber density examinations were collected at baseline and at 3, 6, and 12 months after LCIG infusion was started in the study cohort. RESULTS: After 3, 6, and 12 months, severe skin denervation and increased thermal thresholds were observed in the LCIG group. CONCLUSIONS: Significant damage to small nerve fibers was detected in PDpatients soon after LCIG infusion had started, suggesting careful monitoring of small fiber impairment during LCIG is needed. Muscle Nerve, 2016 Muscle Nerve 54: 970-972, 2016.
Authors: Alberto Romagnolo; Aristide Merola; Carlo Alberto Artusi; Mario Giorgio Rizzone; Maurizio Zibetti; Leonardo Lopiano Journal: Mov Disord Clin Pract Date: 2018-11-08
Authors: Maria Jeziorska; Andrew Atkinson; Lewis Kass-Iliyya; Christopher Kobylecki; David Gosal; Andrew Marshall; Rayaz A Malik; Monty Silverdale Journal: J Parkinsons Dis Date: 2019 Impact factor: 5.568