Objective: Our aim was to see effects of deep brain stimulation (DBS) and continuous infusion of levodopa-carbidopa intestinal gel (LCIG) on nonmotor symptoms in advanced Parkinson’s disease (APD)

Background: The modern management of PD is patient-oriented.  Nonmotor symptoms influence the most quality of life in APD.

Method: We tested 70 patients before and 3 months after DBS and 20 patients before and 3 months after LCIG that came to our Center last year. The investigation was conducted  with anamnesis and treatments’ data, Non-motor Symptom Scale (NMSS), Non Motor Symptoms Questionnaire (NMSQ), Visual Analogue Scale (VAS), McGill questionnaire and Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE), Parkinson’s disease sleep scale (PDSS), Unified Parkinson’s Disease Rating Scale- part II (activities of daily living-ADL), part III (motor examination -ME), Parkinson’s Disease Questionnaire- 39 (PDQ-39)  and levodopa dosage. Statistical analysis was done.

Results: Mean age was 71.09±0.9 (man 56%; women 44%). Mean disease duration was 14.0±0.6. We found statistically significant improvement in nonmotor symptoms (NMSS total score and NMSQ), motor symptoms and PDQ-39 in both methods. Considering subdomains, we found significant beneficial effect on sleep, gastrointestinal, cardiovascular and urological symptoms in both methods, but better improvement in pain and sexual function in DBS and mood and apathy section in LCIG patients (p<0.05).

Conclusion: We found beneficial effects after 3 months with both invasive methods (DBS and LCIG) on nonmotor symptoms and quality of life. The most consistent improvements are seen concerning sleep, cardiovascular, gastrointestinal and urological symptoms. This can help us to decide on advanced therapy for individual 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.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-deep-brain-stimulation-and-continuous-infusion-of-levodopa-carbidopa-intestinal-therapy-on-non-motor-symptoms-in-patients-with-advance-parkinsons-disease/