Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Seville, Spain.
J Neurol. 2014 Mar;261(3):561-9. doi: 10.1007/s00415-013-7235-1. Epub 2014 Jan 30.
The short-term benefits of levodopa/carbidopa intestinal gel (LCIG) in patients with advanced Parkinson's disease (PD) are well documented, but the long-term benefits are still uncertain. The aim of this study was to investigate the motor and cognitive outcome of LCIG treatment in advanced PD after a follow-up period of at least 24 months. We assessed 29 patients with advanced PD who started LCIG infusion at our centre between 2007 and 2013. Motor fluctuations, parkinsonian symptoms, activities of daily living and impact on quality of life were evaluated. We also investigated the cognitive outcome using a battery of neuropsychological tests. All adverse events were recorded. Of the 29 PD patients who initiated LCIG, 16 patients reached the follow-up evaluation (24 months), after a mean time period of 32.2 ± 12.4 months. Six patients did not fulfil the 24-month follow-up visit and were evaluated after a mean time period of 8.6 ± 5.4 months. Seven patients discontinued the treatment before the scheduled visit. "Off" time and "On" dyskinesia duration were significantly reduced. LCIG improved quality of life and non motor symptoms, despite overall unchanged total levodopa doses prior to LCIG beginning. Motor and cognitive decline were detected. A relatively high number of adverse events occurred during the follow-up, above all, technical problems with the infusion device and mild problems related with gastrostomy. There were four cases of peripheral neuropathy (PN), 2 of which were considered serious. Our data confirm that LCIG is beneficial in the long-term treatment of advanced PD patients despite a decline in cognitive functions in a subgroup of patients, probably due to disease progression. PN in patients with LCIG may be more frequent than the published date suggest.
左旋多巴/卡比多巴肠凝胶（LCIG）在晚期帕金森病（PD）患者中的短期益处已有充分记录，但长期益处仍不确定。本研究旨在调查 LCIG 治疗在我们中心接受治疗的 2007 年至 2013 年间开始接受 LCIG 输注的 29 名晚期 PD 患者，随访时间至少为 24 个月。我们评估了晚期 PD 患者的运动波动、帕金森症状、日常生活活动能力和生活质量的影响。我们还使用一系列神经心理学测试来研究认知结果。记录所有不良事件。在开始 LCIG 的 29 名 PD 患者中，有 16 名患者在平均 32.2±12.4 个月后达到了随访评估（24 个月）。6 名患者未完成 24 个月的随访，评估时间平均为 8.6±5.4 个月。7 名患者在预定就诊前停止了治疗。“关闭”时间和“开启”运动障碍持续时间明显减少。LCIG 改善了生活质量和非运动症状，尽管在开始 LCIG 之前，左旋多巴的总剂量总体上没有变化。在随访期间，发现了运动和认知能力下降。发生了相对较高数量的不良事件，尤其是输注装置出现技术问题和与胃造口术相关的轻度问题。有 4 例周围神经病变（PN），其中 2 例被认为是严重的。我们的数据证实，尽管在患者亚组中认知功能下降，但 LCIG 对晚期 PD 患者的长期治疗仍然有益，这可能是由于疾病进展。LCIG 患者的 PN 可能比已发表的数据更为常见。
