Patient‐Perceived Retrospective Outcome of Duodenal Levodopa Infusion in Advanced Parkinson’s Disease

Scott B, Nyholm D.  Patient-Perceived Retroscpective Outcome of Duodenal Levodopa Infusion in Advanced Parkinson’s Disease.  European Neurological Journal, June 2010; 2(1):  3-10

ORIGINAL ARTICLE

Berit Scott ¹ and Dag Nyholm ²

Affiliations: Department of Psychology, and ¹ Department of Neuroscience, Neurology ² , Uppsala University, Sweden

ABSTRACT

Patients with advanced Parkinson’s disease (PD) are dependent on adequate dopaminergic therapy to treat motor and non‐motor fluctuations. Continuous duodenal levodopa/carbidopa infusion is effective in relieving such complications, but patient‐perceived outcome has not been thoroughly investigated so far. The present study retrospectively examined the patient‐perceived frequency, as well as the discomfort, from both motor and non‐motor symptoms before and after levodopa infusion initiation. A questionnaire (n = 68) and a semi‐structured interview (n = 25) were used. A factor analysis was performed on the assembled discomfort data to show which symptoms are more likely to occur simultaneously. The subjects were relieved from symptoms significantly more than having acquired a symptom after initiating levodopa infusion. There was a significant (P<0.01) decrease in discomfort in 17 of 44 symptoms. Different aspects of pain coincided with anxiety, depression, nightmares, cramps, restless legs, and freezing of gait. A strong correlation was found between activities of daily living (ADL) functions and mood. Indexation of questions concerning ADL, sleep, and social relations showed significant improvements after initiation of levodopa infusion therapy. Ninety‐six percent of the 25 patients interviewed strongly recommend the infusion to someone else. The foundation for the patients’ ability to cope with PD relies heavily on adequate dopaminergic stimulation. The duodenal levodopa infusion enhances such a regime by improving ADL function, and thereby mood.

Keywords: Parkinson’s disease, duodenal levodopa infusion, symptom profile, activities of daily living (ADL), social functioning, quality of life, patient‐perceived discomfort
Correspondence: Dag Nyholm, Department of Neuroscience, Neurology, Uppsala University, SE‐75185 Uppsala, Sweden. Tel: (46)‐18‐6115034; Fax: (46)‐18‐6115027; e‐mail: dag.nyholm@neuro.uu.se