Maurizio Zibetti1, Serena Angrisano2, Francesca Dematteis2, Carlo Alberto Artusi2, Alberto Romagnolo2, Aristide Merola3, Leonardo Lopiano2. 1. Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124 Torino, Italy. Electronic address: mzibetti@cittadellasalute.to.it. 2. Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124 Torino, Italy. 3. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
Abstract
OBJECTIVE: To determine the impact of levodopa-carbidopa intestinal gel (LCIG) infusion on different subtypes of freezing of gait (FoG) classified according to levodopa responsiveness in advanced Parkinson disease (PD) patients. METHODS: We retrospectively assessed the presence and severity of FoG in 32 advanced PD patients based on the Unified PD Rating Scale (UPDRS) item 14 score. Different FoG subtypes were inferred from the score variation with oral dopaminergic medications. Modifications following long-term LCIG infusion were analysed. Motor symptoms and motor complications were assessed by UPDRS part III and IV respectively. RESULTS: FoG related UPDRS score varied from 2.6±0.9 in OFF condition to 0.9±0.8 in the ON condition at baseline and improved to 0.6±0.7 with LCIG infusion (p=0.027). After a mean of 2.59±1.12years of continuous LCIG infusion, Pseudo-ON-FoG improved to a greater extent with LCIG infusion than with oral therapy in 12 patients (38%) and equally well in 8 patients (25%), OFF-type-FoG was controlled equally well in 8 patients (25%) and worsened slightly in 3 patients (9%). Unresponsive-FoG, present in one patient (3%), was unmodified by LCIG infusion. CONCLUSIONS: Even though limited by the subjective simple measure of FoG, this study suggests that patients undergoing LCIG infusion maintain a good long-term control of FoG. Pseudo-on-FoG improves in a considerable percentage of patients and OFF-type-FoG remains well controlled with LCIG infusion. Further studies with a larger number of patients and objective measures of FoG are needed to confirm these findings.
OBJECTIVE: To determine the impact of levodopa-carbidopa intestinal gel (LCIG) infusion on different subtypes of freezing of gait (FoG) classified according to levodopa responsiveness in advanced Parkinson disease (PD) patients. METHODS: We retrospectively assessed the presence and severity of FoG in 32 advanced PDpatients based on the Unified PD Rating Scale (UPDRS) item 14 score. Different FoG subtypes were inferred from the score variation with oral dopaminergic medications. Modifications following long-term LCIG infusion were analysed. Motor symptoms and motor complications were assessed by UPDRS part III and IV respectively. RESULTS:FoG related UPDRS score varied from 2.6±0.9 in OFF condition to 0.9±0.8 in the ON condition at baseline and improved to 0.6±0.7 with LCIG infusion (p=0.027). After a mean of 2.59±1.12years of continuous LCIG infusion, Pseudo-ON-FoG improved to a greater extent with LCIG infusion than with oral therapy in 12 patients (38%) and equally well in 8 patients (25%), OFF-type-FoG was controlled equally well in 8 patients (25%) and worsened slightly in 3 patients (9%). Unresponsive-FoG, present in one patient (3%), was unmodified by LCIG infusion. CONCLUSIONS: Even though limited by the subjective simple measure of FoG, this study suggests that patients undergoing LCIG infusion maintain a good long-term control of FoG. Pseudo-on-FoG improves in a considerable percentage of patients and OFF-type-FoG remains well controlled with LCIG infusion. Further studies with a larger number of patients and objective measures of FoG are needed to confirm these findings.
Authors: Vili Viljaharju; Tuomas Mertsalmi; K Amande M Pauls; Maija Koivu; Johanna Eerola-Rautio; Marianne Udd; Eero Pekkonen Journal: Mov Disord Clin Pract Date: 2021-11-04
Authors: Silvia Rota; Daniele Urso; Daniel J van Wamelen; Valentina Leta; Iro Boura; Per Odin; Alberto J Espay; Peter Jenner; K Ray Chaudhuri Journal: Transl Neurodegener Date: 2022-10-13 Impact factor: 9.883