Funding agencies: This study was partially supported by a grant from Ministerio de Ciencia e Innovación, Instituto Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED INTCBN 09/203), Madrid, Spain.
Levodopa infusion improves impulsivity and dopamine dysregulation syndrome in Parkinson's disease
Article first published online: 10 OCT 2013
© 2013 Movement Disorder Society
Volume 28, Issue 14, pages 2007–2010, December 2013
How to Cite
Catalán, M. J., de Pablo-Fernández, E., Villanueva, C., Fernández-Diez, S., Lapeña-Montero, T., García-Ramos, R. and López-Valdés, E. (2013), Levodopa infusion improves impulsivity and dopamine dysregulation syndrome in Parkinson's disease. Mov. Disord., 28: 2007–2010. doi: 10.1002/mds.25636
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 9 DEC 2013
- Article first published online: 10 OCT 2013
- Manuscript Accepted: 14 JUL 2013
- Manuscript Revised: 22 JUN 2013
- Manuscript Received: 22 DEC 2012
- impulse control disorders;
- infusion pumps;
- levodopa, administration and dosage;
- intraduodenal levodopa;
- Parkinson's disease
Impulsivity and dopamine dysregulation syndrome are frequent complications of treatment in Parkinson's disease (PD).
We assessed the effect of jejunal levodopa infusion (JLI) on behavioral symptoms in 8 PD patients with motor complications and severe impulsivity and dopamine dysregulation syndrome (DDS), which had not be controlled before by adjusting oral medications. The infusion was delivered during 15 hours (daily dose 1007.2 ± 302.5 mg) and stopped at night time. Patients were reassessed after 25 ± 9 weeks of treatment with a stable dose of jejunal l-dopa.
Off periods and dyskinesias decreased by 27% and 20,7% respectively, compared to baseline. DDS and all types of impulse control disorders (ICDs) improved in all patients, with nearly complete symptom resolution. Punding improved in all 5 patients but disappeared completely in only 1.
Our experience suggests that l-dopa infusion has a positive effect on both motor complications and behavioral disorders. This treatment approach deserves further controlled studies. © 2013 International Parkinson and Movement Disorder Society