Annamária Juhász1, Zsuzsanna Aschermann1, Péter Ács1, József Janszky2, Márton Kovács1, Attila Makkos1, Márk Harmat1, Dalma Tényi1, Kázmér Karádi3, Sámuel Komoly1, Annamária Takáts4, Adrián Tóth4, Helga Nagy4, Péter Klivényi5, György Dibó5, Lívia Dézsi5, Dénes Zádori5, Ádám Annus5, László Vécsei6, Lajos Varannai7, Norbert Kovács8. 1. Department of Neurology, University of Pécs, Pécs, Hungary. 2. Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroimaging MR Research Group, Pécs, Hungary. 3. Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary. 4. Department of Neurology, Semmelweis University, Budapest, Hungary. 5. Department of Neurology, University of Szeged, Szeged, Hungary. 6. Department of Neurology, University of Szeged, Szeged, Hungary; MTA-SZTE Neuroscience Research Group, Szeged, Hungary. 7. Borsod-Abaúj-Zemplén County Hospital, Miskolc, Hungary. 8. Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroimaging MR Research Group, Pécs, Hungary. Electronic address: kovacsnorbert06@gmail.com.
Abstract
BACKGROUND: Levodopa/carbidopa intestinal gel therapy (LCIG) can efficiently improve several motor and non-motor symptoms of advanced Parkinson's disease (PD). The recently developed Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) improved the original UPDRS making it a more robust tool to evaluate therapeutic changes. However, previous studies have not used the MDS-UPDRS and the Unified Dyskinesia Rating Scale (UDysRS) to assess the efficacy of LCIG. OBJECTIVES: Our aim was to determine if the MDS-UPDRS and UDysRS could detect improvement in the experiences of daily living following 1-year LCIG treatment. METHODS: In this prospective, multicenter, open-label study, 34 consecutive patients undergoing LCIG treatment were enrolled. Patients were examined twice: prior to LCIG initiation and 12 months later. Impact of PD-related symptoms and dyskinesia was assessed by the MDS-UPDRS and UDysRS. RESULTS: Non-motor Experiences of Daily Living part of MDS-UPDRS improved from 20 (median, interquartile-range, IQR:14-23) to 16 points (median, IQR:12-20, p = 0.044) and the Motor Experiences of Daily Living ameliorated from 24 (median, IQR:20-29) to 18 points (median, IQR:13-25, p = 0.025). Health-related quality of life, measured by PDQ-39, also improved from 35.4 (median, IQR:26.9-50.3) to 27.0 (median, IQR:21.3-31.4) points (p = 0.003). The total score of UDysRS decreased from 47 (median, IQR:36-54) to 34 (median, IQR:21-45) points (p = 0.003). CONCLUSIONS: As far as the authors are aware of, our paper is the first to evaluate the impact of LCIG on dyskinesia by the means of UDysRS. Changes in MDS-UPDRS and UDysRS confirm that LCIG treatment can efficiently improve experiences of daily living in advanced PD.
BACKGROUND:Levodopa/carbidopa intestinal gel therapy (LCIG) can efficiently improve several motor and non-motor symptoms of advanced Parkinson's disease (PD). The recently developed Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) improved the original UPDRS making it a more robust tool to evaluate therapeutic changes. However, previous studies have not used the MDS-UPDRS and the Unified Dyskinesia Rating Scale (UDysRS) to assess the efficacy of LCIG. OBJECTIVES: Our aim was to determine if the MDS-UPDRS and UDysRS could detect improvement in the experiences of daily living following 1-year LCIG treatment. METHODS: In this prospective, multicenter, open-label study, 34 consecutive patients undergoing LCIG treatment were enrolled. Patients were examined twice: prior to LCIG initiation and 12 months later. Impact of PD-related symptoms and dyskinesia was assessed by the MDS-UPDRS and UDysRS. RESULTS: Non-motor Experiences of Daily Living part of MDS-UPDRS improved from 20 (median, interquartile-range, IQR:14-23) to 16 points (median, IQR:12-20, p = 0.044) and the Motor Experiences of Daily Living ameliorated from 24 (median, IQR:20-29) to 18 points (median, IQR:13-25, p = 0.025). Health-related quality of life, measured by PDQ-39, also improved from 35.4 (median, IQR:26.9-50.3) to 27.0 (median, IQR:21.3-31.4) points (p = 0.003). The total score of UDysRS decreased from 47 (median, IQR:36-54) to 34 (median, IQR:21-45) points (p = 0.003). CONCLUSIONS: As far as the authors are aware of, our paper is the first to evaluate the impact of LCIG on dyskinesia by the means of UDysRS. Changes in MDS-UPDRS and UDysRS confirm that LCIG treatment can efficiently improve experiences of daily living in advanced PD.
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Authors: József Attila Szász; Viorelia Adelina Constantin; Károly Orbán-Kis; Attila Rácz; Ligia Ariana Bancu; Dan Georgescu; János Szederjesi; István Mihály; Ana-Mária Fárr; Krisztina Kelemen; Tamás Vajda; Szabolcs Szatmári Journal: Neuropsychiatr Dis Treat Date: 2019-11-13 Impact factor: 2.570
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