Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom.
Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy.
J Neurol. 2021 May;268(5):1728-1737. doi: 10.1007/s00415-020-10356-x. Epub 2020 Dec 22.
Levodopa-Carbidopa Intrajejunal gel (LCIG) infusion is an effective intervention for people with advanced Parkinson's disease (PD). Although age may not be a limiting factor for LCIG implant, no data are available on late elderly PD (LE-PD) subjects. In this cross-sectional, we aimed to demonstrate if older age may impact on quality of life (QoL), motor and non-motor symptoms severity, and profile of side effects in PD treated with LCIG.
Out of 512 PD subjects treated with LCIG at 9 Italian PD centers, we selected 25 LE-PD defined as age ≥ 80 years at last follow-up who were available to attend the study visit. Twenty-five PD patients (Control-PD, defined as age < 75 years at last follow-up) matched to LE-PD by disease and LCIG duration served as control group. The following motor and non-motor variables were ascertained: quality of life (PDQ-8), time spent in ON, wearing-off Questionnaire, Unified PD Rating Scale, freezing of gait questionnaire, Parkinson's disease sleep scale-2, Non Motor Symptoms Scale (NMSS), and MOCA.
No statistically significant differences were found between LE-PD and Control-PD on PDQ-8 and several motor and non-motor variables. LE-PD had less frequent and milder impulsive-compulsive behaviors and milder dyskinesia. At multivariable regression, worse quality of life was associated with UPDRS-III and NMSS scores but not to age at study visit and age at LICG implant. Rate of adverse effects was similar in both groups. Drop-out rate calculated in the whole PD cohort was comparable between the two groups.
Our data provide evidence that valuable LCIG infusion might be achieved in late elderly PD.
左旋多巴-卡比多巴肠内凝胶（LCIG）输注是治疗晚期帕金森病（PD）患者的有效干预措施。虽然年龄可能不是 LCIG 植入的限制因素，但尚无关于晚期老年 PD（LE-PD）患者的相关数据。在本横断面研究中，我们旨在证明年龄较大是否会影响接受 LCIG 治疗的 PD 患者的生活质量（QoL）、运动和非运动症状的严重程度以及不良反应的特征。
在意大利 9 个 PD 中心接受 LCIG 治疗的 512 名 PD 患者中，我们选择了 25 名 LE-PD 患者，他们在最后一次随访时的年龄≥80 岁，可参加研究就诊。选择 25 名 PD 患者（对照组 PD，定义为最后一次随访时的年龄<75 岁），按疾病和 LCIG 持续时间与 LE-PD 相匹配作为对照组。确定了以下运动和非运动变量：生活质量（PDQ-8）、ON 时间、停工期问卷、统一 PD 评定量表、冻结步态问卷、帕金森病睡眠量表-2、非运动症状量表（NMSS）和 MoCA。
LE-PD 和对照组 PD 在 PDQ-8 和几个运动和非运动变量上没有统计学上的显著差异。LE-PD 冲动-强迫行为的发生频率较低且程度较轻，运动障碍较轻。在多变量回归中，较差的生活质量与 UPDRS-III 和 NMSS 评分相关，而与研究就诊时的年龄和 LCIG 植入时的年龄无关。两组不良反应的发生率相似。在整个 PD 队列中计算的失访率在两组之间相当。
我们的数据提供了证据，表明在晚期老年 PD 中，LCIG 输注可能是有效的。
