Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson's Disease.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Parkinson's Disease Pub Date : 2020-05-14 eCollection Date: 2020-01-01 DOI:10.1155/2020/1627264

Belén González-Herrero, Serge Jauma-Classen, Roser Gómez-Llopico, Gerard Plans, Matilde Calopa

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引用次数: 2

Abstract

Background: Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson's disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms.

Objective: To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation.

Methods: We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson's Disease Rating Scale before and after intestinal levodopa infusion.

Results: Administration of intestinal levodopa caused improvement of FOG in the "ON" state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson's Disease Rating Scale. The improvement was maintained for at least 12 months.

Conclusions: Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

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肠内左旋多巴/卡比多巴输注治疗帕金森病脑深部刺激后步态无反应性冻结的选择

背景:步态冻结(FOG)由于其不可预测的性质和多因素的生理病理，治疗一直具有挑战性。近年来，肠内左旋多巴输注被认为是一种有价值的改善方法。帕金森病(PD)的FOG可以在没有步态症状的患者进行深部脑刺激后出现。目的:探讨左旋多巴/卡比多巴肠内输注对丘脑下核深部脑刺激治疗PD患者无反应性fog的影响。方法:我们回顾性收集并分析了5例接受丘脑下核刺激治疗的PD患者的人口统计学、临床和治疗数据，这些患者出现了无反应的fog，并接受肠内左旋多巴/卡比多巴输注作为替代治疗。根据肠内左旋多巴输注前后统一帕金森病评定量表第14项的得分来测量FOG。结果:在4例(80%)患者中，给予肠道左旋多巴可使“ON”状态的FOG在统一帕金森病评定量表第14项中提高2分或以上。这种改善至少维持了12个月。结论:肠道左旋多巴输注可能是治疗丘脑下核深部脑刺激后无反应性fog的一种有价值的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Parkinson's Disease CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

3.10%

发文量

审稿时长

18 weeks

期刊介绍： Parkinson’s Disease is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.