Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Institute of Neurology, Largo A. Gemelli, 8, 00168, Rome, Italy.
Fondazione Don Carlo Gnocchi, Milan, Italy.
Neurol Sci. 2017 Oct;38(10):1869-1872. doi: 10.1007/s10072-017-3029-z. Epub 2017 Jun 22.
In recent years, several studies have reported a relatively high frequency of polyneuropathy in patients with Parkinson's disease (PD), in particular, in patients receiving levodopa-carbidopa intestinal gel (LCIG) infusion. In spite of the several patients investigated with nerve conduction studies, no study has prospectively explored a possible central nervous system involvement of patients receiving LCIG infusion. We prospectively evaluated eight PD patients receiving LCIG infusion, who underwent neurophysiological evaluations with nerve conduction studies, visual, somatosensory and motor evoked potentials before LCIG infusion, and 1 and 6 months after. At 6 months follow-up, we found significant reduction in sural nerve SNAP amplitude, increase of central sensory conduction time N22-P40, and increases of central motor conduction time recorded from I dorsal interosseous and tibialis anterior. In PD patients with LCIG infusion, we found a subclinical neurophysiological impairment of both peripheral and central nervous system.
近年来，多项研究报告了帕金森病（PD）患者多发性神经病的相对高发率，特别是接受左旋多巴-卡比多巴肠凝胶（LCIG）输注的患者。尽管有几项研究对神经传导研究进行了调查，但没有研究前瞻性地探讨接受 LCIG 输注的患者可能存在中枢神经系统受累。我们前瞻性地评估了 8 例接受 LCIG 输注的 PD 患者，他们在接受 LCIG 输注前、输注后 1 个月和 6 个月进行了神经生理学评估，包括神经传导研究、视觉、体感和运动诱发电位。在 6 个月的随访中，我们发现腓肠神经 SNAP 振幅显著降低，N22-P40 感觉中枢传导时间延长，I 骨间背侧和胫骨前肌记录的中枢运动传导时间延长。在接受 LCIG 输注的 PD 患者中，我们发现了外周和中枢神经系统的亚临床神经生理学损伤。
