Correlation between the age, motor subtypes and the necessity of advanced therapy in Parkinson disease

Abstract

Levodopa (L-dopa), a precursor of dopamine, remained the gold standard among antiparkinsonian drugs and virtually, in different stages, all patients will require the more powerful symptomatic effect of L-dopa. In addition, continuous Levodopa/Carbidopa intestinal gel (LCIG) infusion therapy, via a percutaneous endoscopic gastrostomy (PEG) and a portable infusion pump, is well established for the treatment of advanced Parkinson's disease (PD), substantially improving motor symptoms and quality of life in these patients. This study aimed to evaluate the necessity of LCGI depending the PD motor subtypes and age at onset of the disease. Seventy patients diagnosed with PD were included in our study. The Unified Parkinson's Disease Rating Scale (UPDRS) was performed in on state. The patients were classified as tremor-dominant type (TDT), akinetic-rigid type (ART) and mixed type (MT). Depending on form of levodopa, thirty-six patients were on L-dopa orally and thirty-four patients were on LCIG. The results of our study showed that there was a statistically significant correlation between the age at onset of PD and the motor subtype of the disease. Also, we observed that the lower the age at diagnosis, the more our patients have reached the need for LCGI. Regarding the motor subtype, our study showed that the mixed typed request more frequent LCGI. Our data show that age and motor profile at onset can predict the necessity of advanced therapy.