Review
Clinical Neurology
Taiji Tsunemi, Genko Oyama, Shinji Saiki, Taku Hatano, Jiro Fukae, Yasushi Shimo, Nobutaka Hattori
Summary: LCIG treatment shows significant efficacy in reducing OFF time, increasing ON time, and improving some nonmotor symptoms and quality of life in Parkinson's disease patients. Discontinuation rates are mainly related to device issues, but the convenience of discontinuation with LCIG may be an advantage.
MOVEMENT DISORDERS
(2021)
Article
Neurosciences
Francesc Valldeoriola, Maria Jose Catalan, Francisco Escamilla-Sevilla, Eric Freire, Jesus Olivares, Esther Cubo, Diego Santos Garcia, Matilde Calopa, Pablo Martinez-Martin, Juan Carlos Parra, Gloria Arroyo, Jose Matias Arbelo
Summary: LCIG has shown significant improvement in quality of life, motor and non-motor symptoms, emotional well-being, and treatment satisfaction in patients with Advanced Parkinson's Disease. Improvement in patient QoL is associated with improvements in various symptoms, while improvements in caregivers' QoL or burden do not necessarily correspond.
NPJ PARKINSONS DISEASE
(2021)
Article
Clinical Neurology
Francesca Morgante, Valentina Oppo, Margherita Fabbri, Enrica Olivola, Chiara Sorbera, Rosa De Micco, Giovanna Chiara Ielo, Fabiana Colucci, Salvatore Bonvegna, Alessio Novelli, Nicola Modugno, Mariachiara Sensi, Maurizio Zibetti, Leonardo Lopiano, Alessandro Tessitore, Manuela Pilleri, Roberto Cilia, Antonio E. Elia, Roberto Eleopra, Lucia Ricciardi, Giovanni Cossu
Summary: The study showed that LCIG infusion can be effective for late elderly Parkinson's disease patients, with no significant differences in quality of life, motor and non-motor symptoms severity, side effects, and dropout rates compared to younger patients.
JOURNAL OF NEUROLOGY
(2021)
Review
Clinical Neurology
Dag Nyholm, Wolfgang H. Jost
Summary: As Parkinson's disease progresses, treatment needs to be adjusted to maintain symptom control. Device-aided therapy, such as levodopa-entacapone-carbidopa intestinal gel (LECIG) infusion, can provide continuous dopaminergic stimulation for patients with advanced PD. LECIG infusion has been shown to be clinically effective, with similar motor function improvement as standard levodopa-carbidopa intestinal gel (LCIG) infusion, but at lower overall levodopa doses. Real-world data will continue to be collected to establish the long-term efficacy and safety of LECIG infusion.
THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS
(2022)
Article
Clinical Neurology
D. Santos-Garcia, M. J. Catalan, V Puente, F. Valldeoriola, I Regidor, P. Mir, J. Matias-Arbelo, J. C. Parra, F. Grandas
Summary: This study found significant variability between autonomous communities in terms of patient selection and the safety and effectiveness of continuous intestinal infusion of levodopa-carbidopa therapy for advanced Parkinson's disease. These differences may have been influenced by patients' baseline characteristics, the availability of multidisciplinary teams, and clinical experience.
Article
Clinical Neurology
Federica Garri, Francesco Paolo Russo, Tommaso Carrer, Luca Weis, Francesca Pistonesi, Michele Mainardi, Michele Sandre, Edoardo Savarino, Fabio Farinati, Francesca Del Sorbo, Paola Soliveri, Daniela Calandrella, Roberta Biundo, Miryam Carecchio, Anna Lena Zecchinelli, Gianni Pezzoli, Angelo Antonini
Summary: This study retrospectively analyzed the usage of LCIG in 79 patients with Parkinson's disease and found that it has a relatively satisfactory long-term safety profile and efficacy, with a low rate of discontinuation. Peristomal complications may be a predictor of longer duration of therapy.
JOURNAL OF NEUROLOGY
(2022)
Article
Pharmacology & Pharmacy
Jozsef Attila Szasz, Viorelia Adelina Constantin, Karoly Orban-Kis, Ligia Ariana Bancu, Simona Maria Bataga, Marius Ciorba, Elod Nagy, Mircea Radu Neagoe, Istvan Mihaly, Robert Mate Szasz, Krisztina Kelemen, Mihaela Simu, Szabolcs Szatmari
Summary: Treatment of Advanced Parkinson's disease using gel form of levodopa administered directly into the upper intestine can improve the quality of life for patients, but there are still unresolved questions that require further investigation.
Article
Clinical Neurology
Nir Giladi, Tanya Gurevich, Ruth Djaldetti, Liat Adar, Ryan Case, Shelly Leibman-Barak, Nissim Sasson, Yoseph Caraco
Summary: ND0612, a continuous subcutaneous levodopa/carbidopa delivery system, was well-tolerated and resulted in reduced OFF time and decreased plasma levodopa fluctuations when used adjunctively in PD patients. Although most patients experienced infusion site nodules, they all resolved without sequelae.
PARKINSONISM & RELATED DISORDERS
(2021)
Article
Health Care Sciences & Services
Goekce Kilincalp, Anne-Christine Sjoestroem, Barbro Eriksson, Bjoern Holmberg, Radu Constantinescu, Filip Bergquist
Summary: The use of Parkinson Kinetigraph (PKG) can predict the response of Parkinson's disease patients to intestinal levodopa/carbidopa gel infusion (LCIG). If "off" periods cannot be clearly observed in the PKG, the treatment effect may be poorer, indicating the need for noninvasive infusion evaluation before surgery.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Pharmacology & Pharmacy
Sheila A. Doggrell
Summary: Parkinson's disease (PD) is a common neurodegenerative disease and the standard treatment is oral medication. However, as the disease progresses, the effectiveness of oral medication decreases, leading to motor fluctuations and dyskinesia. This article discusses the development of subcutaneous preparations for the treatment of motor fluctuations in PD, which show promising results in reducing symptoms.
EXPERT OPINION ON DRUG DELIVERY
(2023)
Article
Clinical Neurology
Rajesh Pahwa, Jason Aldred, Niodita Gupta, Emi Terasawa, Viviana Garcia-Horton, David R. Steffen, Prasanna L. Kandukuri, Vivek S. Chaudhari, Yash J. Jalundhwala, Yanjun Bao, Pavnit Kukreja, Stuart H. Isaacson
Summary: In advanced Parkinson's disease, patients' motor-symptom states and the timing at which they occur can impact patients' quality of life and ability to complete activities of daily living. Carbidopa/levodopa enteral suspension may provide more consistent motor-symptom control throughout the day compared to orally administered carbidopa/levodopa.
NEUROLOGY AND THERAPY
(2022)
Article
Health Care Sciences & Services
Valentina Leta, Haidar S. Dafsari, Anna Sauerbier, Vinod Metta, Nataliya Titova, Lars Timmermann, Keyoumars Ashkan, Michael Samuel, Eero Pekkonen, Per Odin, Angelo Antonini, Pablo Martinez-Martin, Miriam Parry, Daniel J. van Wamelen, K. Ray Chaudhuri
Summary: Currently, device-aided therapies for advanced Parkinson's disease primarily focus on motor symptoms, with non-motor symptoms often only considered as possible exclusion criteria. However, differential effects on specific non-motor symptoms among these therapies have emerged, suggesting potential clinical implications. It is suggested that non-motor symptoms should be used as an additional criterion alongside motor symptoms to provide personalized therapy for advanced PD.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Clinical Neurology
Alfonso Fasano, Rocio Garcia-Ramos, Tanya Gurevich, Robert Jech, Lars Bergmann, Olga Sanchez-Solino, Juan Carlos Parra, Mihaela Simu
Summary: A multinational retrospective study found that long-term use of levodopa-carbidopa intestinal gel (LCIG) can improve motor and nonmotor symptoms in patients with Parkinson's disease, while potentially reducing the need for additional medications.
JOURNAL OF NEUROLOGY
(2023)
Article
Neurosciences
Jozsef Attila Szasz, Viorelia Adelina Constantin, Karoly Orban-Kis, Ligia Ariana Bancu, Marius Ciorba, Istvan Mihaly, Elod Erno Nagy, Robert Mate Szasz, Krisztina Kelemen, Mihaela Adriana Simu, Szabolcs Szatmari
Summary: This study aimed to analyze the evolution of important motor fluctuations and complex disabling dyskinesias under LCIG therapy in patients with APD. Results showed significant improvements in motor fluctuations and dyskinesias after starting LCIG, but an increasing number of patients required longer daily administrations of LCIG.
Article
Clinical Neurology
Rajesh Pahwa, Aristide Merola, Michael Soileau, Ali Alobaidi, A. Simon Pickard, Prasanna L. Kandukuri, Yanjun Bao, John Strezewski, Julia Oddsdottir, Weiwei Xu, David Standaert
Summary: This study aims to compare the cost, quality-adjusted life years (QALY), and cost-effectiveness of Carbidopa/levodopa enteral suspension (CLES) and the standard-of-care (SoC) for Parkinson's disease (PD) patients in the US. The results showed that although CLES is associated with incremental costs, it provides greater QALY gain, making it a cost-effective treatment option for PD patients with medication-resistant motor fluctuations.
MOVEMENT DISORDERS
(2023)
Article
Clinical Neurology
Emanuela Formaggio, Michele Tonellato, Angelo Antonini, Leonora Castiglia, Laura Gallo, Paolo Manganotti, Stefano Masiero, Alessandra Del Felice
Summary: This study aims to explore the pathophysiological mechanisms of Parkinson disease (PD) by examining changes in EEG rhythms after transcranial magnetic stimulation (TMS). The study found that TMS can temporarily normalize brain oscillations in PD patients, providing a theoretical basis for the development of practical, portable techniques to treat PD symptoms.
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
(2023)
Article
Neurosciences
Vanessa Porrini, Andrea Pilotto, Marika Vezzoli, Annamaria Lanzillotta, Michele M. Gennari, Sonia Bonacina, Antonella Alberici, Rosanna Turrone, Arianna Bellucci, Angelo Antonini, Alessandro Padovani, Marina Pizzi
Summary: Although the key neuropathological hallmarks of Parkinson's disease (PD) are known, the underlying pathogenic mechanisms of the disease still need to be elucidated. This study focused on evaluating the levels and activity of c-Rel protein, which may be involved in PD pathophysiology. The findings suggest that PD is characterized by the loss of NF-κB/c-Rel activity, and the reduction of c-Rel DNA-binding could potentially serve as a novel biomarker for PD.
NEUROBIOLOGY OF DISEASE
(2023)
Correction
Clinical Neurology
Federica Garri, Dario Ciprietti, Lisa Lerjefors, Andrea Landi, Manuela Pilleri, Roberta Biundo, Leonardo Salviati, Miryam Carecchio, Angelo Antonini
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Fabrizio Stocchi, Paolo Barone, Giuseppe Bellelli, Andrea Fagiolini, Luigi Ferini Strambi, Sandro Sorbi, Alessandro Padovani
Summary: The diagnosis of depression in Parkinson's disease is challenging due to overlapping symptoms. A panel of Italian specialists reached a consensus that depression is a risk factor for Parkinson's disease, with neuropathological abnormalities playing a role. Multimodal and SSRI antidepressants are confirmed as effective options for treating depression in Parkinson's disease.
NEUROLOGICAL SCIENCES
(2023)
Letter
Clinical Neurology
Federica Garri, Dario Ciprietti, Lisa Lerjefors, Andrea Landi, Manuela Pilleri, Roberta Biundo, Leonardo Salviati, Miryam Carecchio, Angelo Antonini
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Stefanie T. Jost, Agni Konitsioti, Philipp A. Loehrer, Keyoumars Ashkan, Alexandra Rizos, Anna Sauerbier, Maria Gabriela dos Santos Ghilardi, Franz Rosenkranz, Lena Strobel, Alexandra Gronostay, Michael T. Barbe, Julian Evans, Veerle Visser-Vandewalle, Christopher Nimsky, Gereon R. Fink, Monty Silverdale, Rubens G. Cury, Erich T. Fonoff, Angelo Antonini, K. Ray Chaudhuri, Lars Timmermann, Pablo Martinez-Martin, Haidar S. Dafsari
Summary: This study suggests that patients with 'postural instability and gait difficulty' (PIGD) may experience more beneficial non-motor effects compared to patients with 'tremor-dominant' symptoms undergoing deep brain stimulation (DBS) for Parkinson's disease (PD). These differences in clinical efficacy on non-motor aspects should be taken into consideration when advising and monitoring PD patients undergoing DBS.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Neurosciences
Aron Emmi, Stefania Rizzo, Luisa Barzon, Michele Sandre, Elisa Carturan, Alessandro Sinigaglia, Silvia Riccetti, Mila Della Barbera, Rafael Boscolo-Berto, Patrizia Cocco, Veronica Macchi, Angelo Antonini, Monica De Gaspari, Cristina Basso, Raffaele De Caro, Andrea Porzionato
Summary: Neurological manifestations are common in COVID-19 patients, and this study found evidence of SARS-CoV-2 infection in the central nervous system. The researchers observed viral RNA and SARS-CoV-2-immunoreactive neurons in specific regions of the brain in COVID-19 patients. In addition, inflammation was observed in affected brainstem regions, indicating a role of brainstem inflammation in COVID-19. Further investigations are needed to understand the potential implications for neurodegenerative diseases like Parkinson's.
NPJ PARKINSONS DISEASE
(2023)
Article
Clinical Neurology
Angelo Antonini, Aron Emmi, Marta Campagnolo
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Tommaso Carrer, Giulia Bonato, Michele Sandre, Aron Emmi, Marta Campagnolo, Giulia Musso, Miryam Carecchio, Piero Parchi, Angelo Antonini
Summary: This case report presents a female patient with rapidly progressive non-levodopa responsive parkinsonism, gait and balance problems, and dysautonomia, who was diagnosed with MSA Parkinsonian-type (MSA-P). Genetic testing revealed a G2019S mutation in the LRRK2 gene, which has been previously reported in only one other case of pathologically proven MSA. The findings suggest a possible link between G2019S LRRK2 mutation and an increased risk of MSA.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Michele Mainardi, Dario Ciprietti, Manuela Pilleri, Giulia Bonato, Luca Weis, Valeria Cianci, Roberta Biundo, Florinda Ferreri, Massimo Piacentino, Andrea Landi, Andrea Guerra, Angelo Antonini
Summary: This study retrospectively reviewed the clinical efficacy outcomes of 48 DBS-implanted patients and found that both STN-DBS and GPi-DBS are effective in improving motor symptoms severity and complications. However, GPi-DBS has a greater impact on motor fluctuations and motor experiences of daily living.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Alessandro Padovani, Angelo Antonini, Paolo Barone, Giuseppe Bellelli, Andrea Fagiolini, Luigi Ferini Strambi, Sandro Sorbi, Fabrizio Stocchi
Summary: This Delphi study aims to reach a shared point of view among Italian specialists on depression in Alzheimer's disease (AD). Consensus was achieved in most cases (86%), with 80% of statements receiving positive consensus and 6% receiving negative consensus. The study also highlights the strong link between depression and AD, as well as specific features of depression in AD compared to major depressive disorder (MDD).
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Jason Aldred, Eric Freire-Alvarez, Alexander V. Amelin, Angelo Antonini, Bruno Bergmans, Filip Bergquist, Manon Bouchard, Kumar Budur, Camille Carroll, K. Ray Chaudhuri, Susan R. Criswell, Erik H. Danielsen, Florin Gandor, Jia Jia, Thomas E. Kimber, Hideki Mochizuki, Weining Z. Robieson, Amy M. Spiegel, David G. Standaert, Saritha Talapala, Maurizio F. Facheris, Victor S. C. Fung
Summary: This article reports the results of a 52-week open-label registrational trial that evaluated the safety, tolerability, and efficacy of 24-hour foslevodopa/foscarbidopa continuous subcutaneous infusion in patients with advanced Parkinson's disease. The findings suggest that this treatment has the potential to improve motor control, sleep quality, and quality of life in patients with Parkinson's disease.
NEUROLOGY AND THERAPY
(2023)
Review
Anatomy & Morphology
Aron Emmi, Marta Campagnolo, Elena Stocco, Miryam Carecchio, Veronica Macchi, Angelo Antonini, Raffaele De Caro, Andrea Porzionato
Summary: Deep brain stimulation of the Subthalamic Nucleus (STh) is a potential therapy for movement disorders, but the neurochemical and molecular anatomy of the STh remains unclear, especially in humans. By reviewing the literature, we found species-specific differences in the distribution of neurotransmitters in the STh, such as glutamate, GABA, dopamine, serotonin, and noradrenaline, providing a foundation for further research, particularly in humans.
BRAIN STRUCTURE & FUNCTION
(2023)
Article
Clinical Neurology
Eleonora Fiorenzato, Sadaf Moaveninejad, Luca Weis, Roberta Biundo, Angelo Antonini, Camillo Porcaro
Summary: This study suggests that the characteristics of cognitive decline in PD are changes in spontaneous neuronal activity and increased temporal complexity, involving the central executive network (CEN) and default mode network (DMN), possibly reflecting increased segregation of these networks. Therefore, we propose fractal dimension (FD) as a prognostic biomarker of PD-cognitive decline.
MOVEMENT DISORDERS
(2023)
Article
Clinical Neurology
Aron Emmi, Michele Sandre, Francesco Paolo Russo, Giulia Tombesi, Federica Garri, Marta Campagnolo, Miryam Carecchio, Roberta Biundo, Gaya Spolverato, Veronica Macchi, Edoardo Savarino, Fabio Farinati, Piero Parchi, Andrea Porzionato, Luigi Bubacco, Raffaele De Caro, Gabor G. Kovacs, Angelo Antonini
Summary: This study investigated the alterations of alpha-synuclein and glial responses in duodenum biopsies of Parkinson's disease (PD) patients. The findings provide evidence of synuclein pathology and gliosis in the duodenum of PD patients, including early cases, suggesting the important role of the gut in PD pathogenesis.
MOVEMENT DISORDERS
(2023)
Article
Clinical Neurology
Jun-Pyo Hong, Hanim Kwon, Euyhyun Park, Sun-Uk Lee, Chan-Nyoung Lee, Byung-Jo Kim, Ji-Soo Kim, Kun-Woo Park
Summary: In patients with mild-to-moderate PD, vestibular function assessed by video head-impulse tests appears relatively preserved and has minimal impact on the risk of falls. Risk of postural instability is associated with the severity of clinical symptoms in PD.
PARKINSONISM & RELATED DISORDERS
(2024)
Article
Clinical Neurology
Yaqin Xiang, XiuRong Huang, Qian Xu, Zhenhua Liu, Yase Chen, Qiying Sun, Junling Wang, Hong Jiang, Lu Shen, Xinxiang Yan, Beisha Tang, Jifeng Guo
Summary: Using the novel data-driven method DEBM, this study determined the sequence of several common biomarker changes in Parkinson's disease (PD). The left putamen was found to be the earliest biomarker to become abnormal, followed by the right putamen, CSF alpha-synuclein, right caudate, left caudate, and serum NfL. The estimated disease stages showed significant differences between PD and healthy controls, and achieved a high accuracy for distinguishing PD from HC.
PARKINSONISM & RELATED DISORDERS
(2024)
Article
Clinical Neurology
Yan Li, David J. McLernon, Carl E. Counsell, Angus D. Macleod
Summary: This study aimed to investigate the incidence and risk factors for institutionalisation in Parkinson's disease (PD) and atypical parkinsonism (AP). The study found that institutionalisation was more frequent in AP compared to PD and controls. Age, poorer cognition, and more-severe parkinsonian impairment were independent predictors of institutionalisation.
PARKINSONISM & RELATED DISORDERS
(2024)