Roberta De Fiores , Iolanda Martino , Andrea Quattrone , Basilio Vescio , Gennarina Arabia , Antonio Gambardella , Maurizio Morelli
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For each, we identified the first end-of-dose deterioration period through MDS-UPDRS-III administered every 30 min over two consecutive days. On the third day, a comprehensive clinical and neuropsychological battery was administered during this designated period. Subsequently, OPC was prescribed to PD-OPC. After 6 months, patients were re-evaluated using the same baseline assessments during the same end-of-dose period.</div></div><div><h3>Results</h3><div>At 6-month follow-up, PD-OPC showed significant improvement in the following tests: WOQ-19 (<em>p</em> < 0.001), total MDS-UPDRS and each of its four parts (<em>p</em> < 0.001), NMSS (<em>p</em> < 0.001), executive functions/attention (Weigl’s, <em>p</em> < 0.001; FAS, <em>p</em> < 0.001; FAB, <em>p</em> < 0.001; STROOP, <em>p</em> = 0.001) and mood related-symptoms (BDI-II, HAM-A; both <em>p</em> = 0.001). There was a slightly significant difference in Visual Search (<em>p</em> = 0.018), and no differences in RAVLT-I <em>(p</em> = 0.323), and RAVLT-D (<em>p</em> = 0.155) scores. At follow-up, PD-CTRL showed no significant differences in WOQ-19, motor scales, and neuropsychological tests compared to baseline.</div></div><div><h3>Conclusion</h3><div>OPC improved end-of-dose fluctuations in anxiety/depression, and executive functions/attention, while memory and visuospatial abilities showed little or no significant changes.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100343"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Opicapone improves end-of-dose neuropsychiatric fluctuations in patients with Parkinson’s disease\",\"authors\":\"Roberta De Fiores , Iolanda Martino , Andrea Quattrone , Basilio Vescio , Gennarina Arabia , Antonio Gambardella , Maurizio Morelli\",\"doi\":\"10.1016/j.prdoa.2025.100343\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Non-motor fluctuations (NMF) represent one of the main complications that patients with Parkinson’s disease (PD) may experience during long-term levodopa treatment. Opicapone (OPC), a COMT-inhibitor indicated for end-of-dose motor fluctuations (MF), has not been extensively investigated for the management of NMF. We evaluate the efficacy of OPC on end-of-dose neuropsychiatric fluctuations, the most frequent and severe NMF.</div></div><div><h3>Methods</h3><div>We assessed 15 PD patients who underwent treatment with OPC (PD-OPC) compared to a control group of 15 PD patients (PD-CTRL). All patients had end-of-dose MF and NMF, confirmed by 19-item Wearing-Off Questionnaire (WOQ-19). For each, we identified the first end-of-dose deterioration period through MDS-UPDRS-III administered every 30 min over two consecutive days. On the third day, a comprehensive clinical and neuropsychological battery was administered during this designated period. Subsequently, OPC was prescribed to PD-OPC. After 6 months, patients were re-evaluated using the same baseline assessments during the same end-of-dose period.</div></div><div><h3>Results</h3><div>At 6-month follow-up, PD-OPC showed significant improvement in the following tests: WOQ-19 (<em>p</em> < 0.001), total MDS-UPDRS and each of its four parts (<em>p</em> < 0.001), NMSS (<em>p</em> < 0.001), executive functions/attention (Weigl’s, <em>p</em> < 0.001; FAS, <em>p</em> < 0.001; FAB, <em>p</em> < 0.001; STROOP, <em>p</em> = 0.001) and mood related-symptoms (BDI-II, HAM-A; both <em>p</em> = 0.001). There was a slightly significant difference in Visual Search (<em>p</em> = 0.018), and no differences in RAVLT-I <em>(p</em> = 0.323), and RAVLT-D (<em>p</em> = 0.155) scores. 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引用次数: 0
摘要
非运动波动(NMF)是帕金森病(PD)患者长期左旋多巴治疗期间可能出现的主要并发症之一。Opicapone (OPC),一种用于治疗剂量末运动波动(MF)的comt抑制剂,尚未被广泛研究用于治疗NMF。我们评估了OPC对最常见和最严重的NMF的剂量末神经精神波动的疗效。方法我们评估了15例接受OPC治疗的PD患者(PD-OPC)与对照组15例PD患者(PD- ctrl)。所有患者均有剂量末MF和NMF,由19项磨损问卷(WOQ-19)证实。对于每一个,我们通过连续两天每30分钟给药的MDS-UPDRS-III确定了第一个剂量末恶化期。在第三天,在指定的时间内进行全面的临床和神经心理学测试。随后给PD-OPC开OPC。6个月后,在相同的给药结束期间,使用相同的基线评估对患者进行重新评估。结果随访6个月后,PD-OPC在以下各项指标均有显著改善:WOQ-19 (p <;0.001),总MDS-UPDRS及其四个部分(p <;0.001), NMSS (p <;0.001),执行功能/注意力(Weigl 's, p <;0.001;FAS, p <;0.001;FAB, p <;0.001;STROOP, p = 0.001)和情绪相关症状(BDI-II, HAM-A;p均= 0.001)。两组在视觉搜索(Visual Search)得分上差异有统计学意义(p = 0.018),在RAVLT-I (p = 0.323)和RAVLT-D (p = 0.155)得分上差异无统计学意义。随访时,PD-CTRL在WOQ-19、运动量表和神经心理测试方面与基线相比无显著差异。结论opc改善了焦虑/抑郁和执行功能/注意力的剂量末波动,而记忆和视觉空间能力的变化很少或没有显著变化。
Opicapone improves end-of-dose neuropsychiatric fluctuations in patients with Parkinson’s disease
Introduction
Non-motor fluctuations (NMF) represent one of the main complications that patients with Parkinson’s disease (PD) may experience during long-term levodopa treatment. Opicapone (OPC), a COMT-inhibitor indicated for end-of-dose motor fluctuations (MF), has not been extensively investigated for the management of NMF. We evaluate the efficacy of OPC on end-of-dose neuropsychiatric fluctuations, the most frequent and severe NMF.
Methods
We assessed 15 PD patients who underwent treatment with OPC (PD-OPC) compared to a control group of 15 PD patients (PD-CTRL). All patients had end-of-dose MF and NMF, confirmed by 19-item Wearing-Off Questionnaire (WOQ-19). For each, we identified the first end-of-dose deterioration period through MDS-UPDRS-III administered every 30 min over two consecutive days. On the third day, a comprehensive clinical and neuropsychological battery was administered during this designated period. Subsequently, OPC was prescribed to PD-OPC. After 6 months, patients were re-evaluated using the same baseline assessments during the same end-of-dose period.
Results
At 6-month follow-up, PD-OPC showed significant improvement in the following tests: WOQ-19 (p < 0.001), total MDS-UPDRS and each of its four parts (p < 0.001), NMSS (p < 0.001), executive functions/attention (Weigl’s, p < 0.001; FAS, p < 0.001; FAB, p < 0.001; STROOP, p = 0.001) and mood related-symptoms (BDI-II, HAM-A; both p = 0.001). There was a slightly significant difference in Visual Search (p = 0.018), and no differences in RAVLT-I (p = 0.323), and RAVLT-D (p = 0.155) scores. At follow-up, PD-CTRL showed no significant differences in WOQ-19, motor scales, and neuropsychological tests compared to baseline.
Conclusion
OPC improved end-of-dose fluctuations in anxiety/depression, and executive functions/attention, while memory and visuospatial abilities showed little or no significant changes.