Effects of continuous subcutaneous apomorphine infusion in Parkinson's disease without cognitive impairment on motor, cognitive, psychiatric symptoms and quality of life

J Neurol Sci. 2018 Dec 15:395:113-118. doi: 10.1016/j.jns.2018.10.010. Epub 2018 Oct 7.

Abstract

Introduction: Treatment optimization using continuous subcutaneous apomorphine infusion (CSAI) improves the control of motor fluctuations of patients with Parkinson's disease (PD). Although CSAI seems to be cognitively and behaviorally safe and to improve the quality of life, very few studies have investigated its influence in these domains, especially in patients without cognitive impairment.

Methods: We estimated the impact of CSAI on motor symptoms, cognition, psychiatric domains and quality of life in parkinsonian patients without cognitive impairment by comparing the scores of 22 patients assessed before and 6 months after the start of add-on CSAI.

Results: Optimized treatment with CSAI was associated with i) reduced motor fluctuations, ii) unchanged cognition, iii) unchanged psychiatric domains, and iv) improved quality of life in physical and psychological aspects.

Conclusion: In PD patients without cognitive impairment, CSAI improves motor symptoms and quality of life and, as suggested by previous studies, alters neither cognition nor mental health.

MeSH terms

  • Antiparkinson Agents / administration & dosage*
  • Apomorphine / administration & dosage*
  • Cognition / drug effects
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Subcutaneous
  • Levodopa / administration & dosage
  • Male
  • Mental Disorders / psychology
  • Middle Aged
  • Motor Activity / drug effects
  • Neuropsychological Tests
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / psychology*
  • Quality of Life
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa
  • Apomorphine