Objective: In this study we want to see what are the hardest and the most troublesome symptoms perceived by patients with Parkinson’s disease (PD) before and 3 months after deep brain stimulation (DBS) and continuous infusion of levodopa-carbidopa intestinal gel (LCIG).

Background: The modern management of PD is patient-oriented. Patients have a lot of motor and non-motor symptoms but their perceptions of the hardest and the most troublesome symptoms mostly differ from the doctor’s view. If we want to manage them effectively, we have to focus on patients’ perspective.

Methods: We asked 50 patients before and 3 months after DBS and 12 patients before and 3 months after LCIG that came last year to our Centre to write their three most troublesome and the hardest symptoms and problems in last 3 months. Also, we collected all other demographic data about them.

Results: Mean age was 70.09±0.9 (man 57%; women 43%). Mean disease duration was 14.3±0.6. Before DBS and LCIG the most troublesome symptoms and problems of PD patients were similar: slowness (48.1%), gait (46.2%), tremor (33.3%), rigidity (33.3%), falls (12.9%) and unpredictable response to their medication (12.9%). 3 months after DBS the most troublesome symptoms and problems were gait (26.2%), fear of malfunctioning of DBS (23%), apathy (12%), worry about longevity of good effects of DBS (15%), trouble speaking (10%) and weight gain (5%). After LCIG the most troublesome symptoms and problems were coping with pump and maintenance (30%), gait (28.2%), slowness (15.1%), weight loss (13%), weakness (12%) and burning and pricking in legs (10%).

Conclusions: The hardest symptoms and problems in PD patients were different before and 3 months after invasive treatments. Although DBS and LCIG in PD are successful in reducing motor symptoms, our study has shown that we have to pay more attention to assess and control non-motor symptoms and psycho-social factors after them because they may impact patients’ ability to access and continue successful therapy. We have to find more effective new techniques to control these symptoms better and improve more quality of life of PD patients.

References: 1. Hariz GM, Hamberg K. Perceptions of living with a device-based treatment: an account of patients treated with deep brain stimulation for Parkinson’s disease. Neuromodulation 2014;17:272–8. 2. Reich M, Chaudhuri K, Ashkan K, et al: Changes in the non-motor symptom scale in Parkinson’s disease after deep brain stimulation. Basal Ganglia 2011, 1:131–133. 3. Nisenzon AN, Robinson ME, Bowers D, Banou E, Malaty I, Okun MS: Measurement of patient-centered outcomes in parkinson: what do patients really want from their treatment? Parkinsonism Relat Disord 2011,17:89–94.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/the-hardest-symptoms-that-bother-patients-with-parkinsons-disease-before-and-3-months-after-deep-brain-stimulation-and-continuous-infusion-of-levodopa-carbidopa-intestinal-therapy/