使用MNCD分类法监测晚期帕金森病的临床分期及对左旋多巴-恩他卡朋-卡比多巴肠凝胶输注的反应

Use of the MNCD Classification to Monitor Clinical Stage and Response to Levodopa-Entacapone-Carbidopa Intestinal Gel Infusion in Advanced Parkinson's Disease.

作者信息

Santos-García Diego, López-Manzanares Lydia, Muro Inés, Lorenzo-Barreto Pablo, Casas Peña Elena, García-Ramos Rocío, Fernández Valle Tamara, Morata-Martínez Carlos, Baviera-Muñoz Raquel, Martínez-Torres Irene, Álvarez-Sauco María, Alonso-Modino Déborah, Legarda Inés, Valero-García María Fuensanta, Suárez-Muñoz José Andrés, Martínez-Castrillo Juan Carlos, Perona Ana Belén, Salom Jose María, Cubo Esther, Valero-Merino Caridad, López-Ariztegui Nuria, Alonso Pilar Sánchez, Novo Ponte Sabela, Gamo Gónzález Elisa, Martín García Raquel, Espinosa Raúl, Carmona Mar, Feliz Cici Esmerali, García Ruíz Pedro, Muñoz Ruíz Teresa, Fernández Rodríguez Beatriz, Alvarez-Santullano Marina Mata

机构信息

Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006 A Coruña, Spain.

Grupo de Investigación en Enfermedad de Parkinson y otros Trastornos del Movimiento, INIBIC (Instituto de Investigación Biomédica de A Coruña), 15006 A Coruña, Spain.

出版信息

Brain Sci. 2024 Dec 12;14(12):1244. doi: 10.3390/brainsci14121244.

DOI:10.3390/brainsci14121244

PMID:39766443

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11674033/

Abstract

BACKGROUND AND OBJECTIVE

Staging Parkinson's disease (PD) with a novel simple classification called MNCD, based on four axes (Motor; Non-motor; Cognition; Dependency) and five stages, correlated with disease severity, patients' quality of life and caregivers' strain and burden. Our aim was to apply the MNCD classification in advanced PD patients treated with device-aided therapy (DAT).

PATIENTS AND METHODS

A multicenter observational retrospective study of the first patients to start the levodopa-entacapone-carbidopa intestinal gel (LECIG) in Spain was performed (LECIPARK study). The MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) were collected by the neurologist at V0 (before starting LECIG) and V2 (follow-up visit). Wilcoxon's signed rank and Marginal Homogeneity tests were applied to compare changes from V0 to V2.

RESULTS

Sixty-seven PD patients (58.2% males; 69.9 ± 9.3 years old) with a mean disease duration of 14.4 ± 6.5 years were included. The mean treatment duration (V2) was 172.9 ± 105.2 days. At V0, patients were classified as in stage 2 (35.8%), 3 (46.3%) or 4 (17.9%). The frequency of patients in stage 4 decreased to 9% at V2 ( = 0.001). The MNCD total score decreased from 6.27 ± 1.94 at V0 to 5.21 ± 2.23 ( < 0.0001). From V0 to V2, the motor (M; < 0.0001) and non-motor symptom (N; < 0.0001) burden decreased, and autonomy for the activities of daily living (D; = 0.005) improved.

CONCLUSIONS

The MNCD classification could be useful to classify advanced PD patients and to monitor the response to a DAT.

摘要

背景与目的

基于运动、非运动、认知、依赖四个轴和五个阶段，采用一种名为MNCD的新型简单分类法对帕金森病（PD）进行分期，该分期与疾病严重程度、患者生活质量以及照料者的压力和负担相关。我们的目的是将MNCD分类法应用于接受器械辅助治疗（DAT）的晚期PD患者。

患者与方法

对西班牙首批开始使用左旋多巴 - 恩他卡朋 - 卡比多巴肠凝胶（LECIG）的患者进行了一项多中心观察性回顾性研究（LECIPARK研究）。神经科医生在V0（开始使用LECIG之前）和V2（随访就诊）时收集MNCD总分（范围为0至12）和MNCD分期（范围为1至5）。应用Wilcoxon符号秩检验和边际齐性检验来比较从V0到V2的变化。

结果

纳入了67例PD患者（男性占58.2%；年龄69.9±9.3岁），平均病程为14.4±6.5年。平均治疗时长（V2）为172.9±105.2天。在V0时，患者被分类为2期（35.8%）、3期（46.3%）或4期（17.9%）。在V2时，4期患者的比例降至9%（P = 0.001）。MNCD总分从V0时的6.27±1.94降至5.21±2.23（P < 0.0001）。从V0到V2，运动（M；P < 0.0001）和非运动症状（N；P < 0.0001）负担减轻，日常生活活动自主性（D；P = 0.005）改善。