Switching and combining device-aided therapies in advanced Parkinson’s disease

ǂa ǂdouble centre retrospective study

Dejan Georgiev (Avtor), Sentilija Delalić (Avtor), Nina Zupančič-Križnar (Avtor), Achinoam Socher (Avtor), Tanya Gurevich (Avtor), Maja Trošt (Avtor)

Povzetek

Background: Device-aided therapies (DAT), such as continuous subcutaneous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel infusion (LCIG), and deep brain stimulation of the subthalamic nucleus (STN-DBS), have markedly changed the treatment landscape of advanced Parkinson’s disease (aPD). In some patients, it is necessary to switch or combine DATs for various reasons. The aim of this retrospective study was to explore the frequency and reasons for switching between or combining DATs in two movement disorders centres in Slovenia and Israel. Methods: We collected and analysed demographic and clinical data from aPD patients who switched between or combined DATs. Motor and non-motor reasons, adverse events for switching/combining, and their frequency were examined, as was the effect of DAT using the Global Improvement subscale of the Clinical Global Impression Scale, Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III, Mini Mental State Examination, and Parkinson’s Disease Questionnaire 39. Descriptive statistics and non-parametric tests were used to analyse the data. Results: Of 505 aPD patients treated with DATs at both centres between January 2009 and June 2021, we identified in a total of 30 patients (6%) who either switched DAT (n = 24: 7 LCIG-to-STN−DBS, 1 LCIG-to-CSAI, 5 CSAI-to STN−DBS, 8 CSAI-to-LCIG, 1 STN−DBS-to-LCIG, 1 LCIG-to-CSAI-to-STN−DBS, and 1 STN−DBS-to-CSAI-to-LCIG) or combined DATs (n = 6:5 STN−DBS+LCIG and 1 STN−DBS+CSAI-to-STN−DBS+LCIG). In most of these patients, an inadequate control of motor symptoms was the main reason for switching or combining DATs, but non-motor reasons (related to the disease and/or DAT) were also identified. Conclusions: Switching between and combining DATs is uncommon, but in some patients brings substantial clinical improvement and should be considered in those who have either inadequate symptom control on DAT treatment or have developed DAT-related complications.

Ključne besede

nevrologija;Parkinsonova bolezen;globoka možganska stimulacija;levodopa;motnje gibanja;

Podatki

Jezik:	Angleški jezik
Leto izida:	2022
Tipologija:	1.01 - Izvirni znanstveni članek
Organizacija:	UL FRI - Fakulteta za računalništvo in informatiko
UDK:	616.8
COBISS:	99397635
ISSN:	2076-3425
Št. ogledov:	85
Št. prenosov:	22
Ocena:	0 (0 glasov)
Metapodatki:

Ostali podatki

Sekundarni jezik:	Slovenski jezik
Sekundarne ključne besede:	nevrologija;Parkinsonova bolezen;globoka možganska stimulacija;levodopa;motnje gibanja;
Vrsta dela (COBISS):	Članek v reviji
Strani:	str. 1-10
Letnik:	ǂVol. ǂ12
Zvezek:	ǂiss. ǂ3
Čas izdaje:	2022
DOI:	10.3390/brainsci12030343
ID:	15574425