Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Turin, Italy.
Eur J Neurol. 2019 Mar;26(3):490-496. doi: 10.1111/ene.13844. Epub 2018 Nov 18.
Weight loss (WL) is a frequent yet under-recognized complication of levodopa/carbidopa intestinal gel (LCIG) infusion, as well as a milestone of Parkinson's disease (PD) disability progression. The complex association between WL, poor nutritional status, motor complications and PD progression, however, remains unclear.
Consecutive consenting patients with PD treated with LCIG (n = 44; PD duration, 18.3 ± 6.5 years) were enrolled in an open-label observational study assessing the extent of WL occurring during LCIG treatment. As secondary aims, we correlated the nutritional status, as detected by the Mini Nutritional Assessment, with the severity of motor symptoms [Movement Disorder Society Unified Parkinson's Disease Rating Scale part III], motor complications (Unified Parkinson's Disease Rating Scale part IV), activities of daily living (Schwab and England scale), cognitive impairment (Mini Mental State Examination), depression (Beck Depression Inventory), difficulties in feeding (Edinburgh Feeding Evaluation in Dementia Questionnaire) and levodopa equivalent daily dose (LEDD).
There was an average WL of 9.9 ± 10.5% (7.6 ± 7.1 kg) over an LCIG treatment period of 51.6 ± 28.5 months. The extent of WL correlated with the percentage of the waking day spent with dyskinesia (P < 0.05). The nutritional status correlated with motor symptom severity (P < 0.01), dysphagia (P < 0.01) and LEDD (P < 0.01).
Weight loss may occur in patients with PD undergoing LCIG in correlation with the percentage of the waking day spent with dyskinesia. Regardless of the extent of WL, the nutritional status correlated with higher LEDD, as well as with indices of disease progression, such as motor symptom severity and dysphagia.
体重减轻（WL）是左旋多巴/卡比多巴肠凝胶（LCIG）输注的常见但未被充分认识的并发症，也是帕金森病（PD）残疾进展的一个里程碑。然而，WL、营养状况不良、运动并发症和 PD 进展之间的复杂关系仍不清楚。
连续同意接受 LCIG 治疗的 PD 患者（n=44；PD 病程 18.3±6.5 年）被纳入一项开放标签观察性研究，评估 LCIG 治疗过程中 WL 的程度。作为次要目标，我们将 Mini Nutritional Assessment 检测到的营养状况与运动症状的严重程度（运动障碍协会统一帕金森病评定量表第 III 部分）、运动并发症（统一帕金森病评定量表第 IV 部分）、日常生活活动（Schwab 和 England 量表）、认知障碍（简易精神状态检查）、抑郁（贝克抑郁量表）、进食困难（痴呆症的爱丁堡进食评估问卷）和左旋多巴等效日剂量（LEDD）进行相关性分析。
LCIG 治疗期间平均 WL 为 9.9±10.5%（7.6±7.1kg），治疗时间为 51.6±28.5 个月。WL 的程度与清醒时出现不自主运动的时间百分比相关（P<0.05）。营养状况与运动症状严重程度（P<0.01）、吞咽困难（P<0.01）和 LEDD（P<0.01）相关。
接受 LCIG 治疗的 PD 患者可能会出现体重减轻，与清醒时出现不自主运动的时间百分比相关。无论 WL 的程度如何，营养状况与更高的 LEDD 以及疾病进展的指标（如运动症状严重程度和吞咽困难）相关。
