TY - JOUR
T1 - Combined and sequential treatment with deep brain stimulation and continuous intrajejunal levodopa infusion for parkinson’s disease
AU - van Poppelen, Daniël
AU - Tromp, Annelie N. M.
AU - de Bie, Rob M. A.
AU - Dijk, Joke M.
N1 - Funding Information: Conflicts of Interest: D.v.P. and A.N.M.T. report no financial disclosure. J.M.D. received funding for research from ZonMw (governmental funding organization) and an unrestricted research grant from Medtronic for a study comparing treatment with DBS and CLI in advanced Parkinson’s disease; further unrestricted funding received from “Stichting Parkinson Nederland” (PD research foundation) and Amsterdam Neuroscience. R.M.A.d.B. received funding for research from ZonMw (governmental funding organization), the Parkinson Vereniging (patient organization) and an unrestricted research grant form Lysosomal Therapeutics, GE Health, Medtronic, and NeuroDerm. These funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - (1) Background: Deep brain stimulation (DBS) and continuous intrajejunal levodopa infusion (CLI) are efficacious treatments of medication related motor response fluctuations in advanced Parkinson’s disease (PD). Literature regarding the use of both advanced treatments within one patient is scarce. (2) Methods: We present a retrospective single center case series and a review of the literature. Patients with PD who were treated with both DBS and CLI in our tertiary referral center between 2005 and 2020 were identified and medical records were assessed. Additionally, literature on patients treated with both therapies was systematically searched for in Medline and Embase. (3) Results: Nineteen patients were included. Medication related motor response fluctuations were a major indication for the second therapy in all but one. Of nine patients initially treated with DBS, five reported improvement with CLI. Seven of ten patients initially treated with CLI experienced benefits from DBS. The systematic literature search resulted in fifteen previous publications comprising 66 patients. Of the 59 patients, for whom the effect of the second treatment was known, 57 improved. (4) Conclusions: PD patients, who have persisting medication related motor response fluctuations, despite DBS or CLI treatment, may benefit from an additional or alternative treatment with either CLI or DBS.
AB - (1) Background: Deep brain stimulation (DBS) and continuous intrajejunal levodopa infusion (CLI) are efficacious treatments of medication related motor response fluctuations in advanced Parkinson’s disease (PD). Literature regarding the use of both advanced treatments within one patient is scarce. (2) Methods: We present a retrospective single center case series and a review of the literature. Patients with PD who were treated with both DBS and CLI in our tertiary referral center between 2005 and 2020 were identified and medical records were assessed. Additionally, literature on patients treated with both therapies was systematically searched for in Medline and Embase. (3) Results: Nineteen patients were included. Medication related motor response fluctuations were a major indication for the second therapy in all but one. Of nine patients initially treated with DBS, five reported improvement with CLI. Seven of ten patients initially treated with CLI experienced benefits from DBS. The systematic literature search resulted in fifteen previous publications comprising 66 patients. Of the 59 patients, for whom the effect of the second treatment was known, 57 improved. (4) Conclusions: PD patients, who have persisting medication related motor response fluctuations, despite DBS or CLI treatment, may benefit from an additional or alternative treatment with either CLI or DBS.
KW - Deep brain stimulation
KW - Levodopa
KW - Levodopa/carbidopa enteral infusion
KW - Parkinson’s disease
UR - http://www.scopus.com/inward/record.url?scp=85108692121&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jpm11060547
DO - https://doi.org/10.3390/jpm11060547
M3 - Review article
C2 - 34204708
SN - 2075-4426
VL - 11
JO - Journal of personalized medicine
JF - Journal of personalized medicine
IS - 6
M1 - 547
ER -