Francesca Morgante1,2, Valentina Oppo3, Margherita Fabbri4, Enrica Olivola5, Chiara Sorbera6, Rosa De Micco7, Giovanna Chiara Ielo8, Fabiana Colucci9, Salvatore Bonvegna10, Alessio Novelli10, Nicola Modugno5, Mariachiara Sensi9, Maurizio Zibetti11, Leonardo Lopiano11, Alessandro Tessitore7, Manuela Pilleri8, Roberto Cilia10, Antonio E Elia10, Roberto Eleopra10, Lucia Ricciardi12,13, Giovanni Cossu14. 1. Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom. fmorgant@sgul.ac.uk. 2. Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy. fmorgant@sgul.ac.uk. 3. Movement Disorders and Neurophysiology Unit, Department of Neuroscience, AO Brotzu, Piazzale Ricchi 1, Cagliari, 09134, Italy. 4. Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse expert center, NS-Park/FCRIN network and NeuroToul COEN center, TOULOUSE University Hospital, INSERM, University of Toulouse 3, Toulouse, France. 5. Unit of Neurology, IRCCS Neuromed, Pozzilli, IS, Italy. 6. Neurorehabilitation Unit, IRCCS Centro Neurolesi "Bonino Pulejo,", Messina, Italy. 7. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. 8. Service of Neurology, Private Hospital, Villa Margherita-Santo Stefano, Arcugnano, Italy. 9. Department of Neuroscience and Rehabilitation, Azienda Ospedaliera-Universitaria S. Anna, Ferrara, Italy. 10. Movement Disorder Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. 11. Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy. 12. Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom. 13. MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, Oxford, UK. 14. Movement Disorders and Neurophysiology Unit, Department of Neuroscience, AO Brotzu, Piazzale Ricchi 1, Cagliari, 09134, Italy. giovannicossu@aob.it.
Abstract
OBJECTIVES: Levodopa-Carbidopa Intrajejunal gel (LCIG) infusion is an effective intervention for people with advanced Parkinson's disease (PD). Although age may not be a limiting factor for LCIG implant, no data are available on late elderly PD (LE-PD) subjects. In this cross-sectional, we aimed to demonstrate if older age may impact on quality of life (QoL), motor and non-motor symptoms severity, and profile of side effects in PD treated with LCIG. METHODS: Out of 512 PD subjects treated with LCIG at 9 Italian PD centers, we selected 25 LE-PD defined as age ≥ 80 years at last follow-up who were available to attend the study visit. Twenty-five PD patients (Control-PD, defined as age < 75 years at last follow-up) matched to LE-PD by disease and LCIG duration served as control group. The following motor and non-motor variables were ascertained: quality of life (PDQ-8), time spent in ON, wearing-off Questionnaire, Unified PD Rating Scale, freezing of gait questionnaire, Parkinson's disease sleep scale-2, Non Motor Symptoms Scale (NMSS), and MOCA. RESULTS: No statistically significant differences were found between LE-PD and Control-PD on PDQ-8 and several motor and non-motor variables. LE-PD had less frequent and milder impulsive-compulsive behaviors and milder dyskinesia. At multivariable regression, worse quality of life was associated with UPDRS-III and NMSS scores but not to age at study visit and age at LICG implant. Rate of adverse effects was similar in both groups. Drop-out rate calculated in the whole PD cohort was comparable between the two groups. CONCLUSION: Our data provide evidence that valuable LCIG infusion might be achieved in late elderly PD.
OBJECTIVES:Levodopa-Carbidopa Intrajejunal gel (LCIG) infusion is an effective intervention for people with advanced Parkinson's disease (PD). Although age may not be a limiting factor for LCIG implant, no data are available on late elderly PD (LE-PD) subjects. In this cross-sectional, we aimed to demonstrate if older age may impact on quality of life (QoL), motor and non-motor symptoms severity, and profile of side effects in PD treated with LCIG. METHODS: Out of 512 PD subjects treated with LCIG at 9 Italian PD centers, we selected 25 LE-PD defined as age ≥ 80 years at last follow-up who were available to attend the study visit. Twenty-five PD patients (Control-PD, defined as age < 75 years at last follow-up) matched to LE-PD by disease and LCIG duration served as control group. The following motor and non-motor variables were ascertained: quality of life (PDQ-8), time spent in ON, wearing-off Questionnaire, Unified PD Rating Scale, freezing of gait questionnaire, Parkinson's diseasesleep scale-2, Non Motor Symptoms Scale (NMSS), and MOCA. RESULTS: No statistically significant differences were found between LE-PD and Control-PD on PDQ-8 and several motor and non-motor variables. LE-PD had less frequent and milder impulsive-compulsive behaviors and milder dyskinesia. At multivariable regression, worse quality of life was associated with UPDRS-III and NMSS scores but not to age at study visit and age at LICG implant. Rate of adverse effects was similar in both groups. Drop-out rate calculated in the whole PD cohort was comparable between the two groups. CONCLUSION: Our data provide evidence that valuable LCIG infusion might be achieved in late elderly PD.
Entities:
Keywords:
Dyskinesia; Levodopa–carbidopa intestinal gel (LCIG); Motor fluctuations; Old age; Parkinson’s disease; Quality of life
Authors: Gökçe Kilinçalp; Anne-Christine Sjöström; Barbro Eriksson; Björn Holmberg; Radu Constantinescu; Filip Bergquist Journal: J Pers Med Date: 2022-01-02