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Title

Apomorphine infusion in advanced Parkinson's patients with subthalamic stimulation contraindications
Authors
Drapier, Sophie
Gillioz, Anne-Sophie
Leray, Emmanuelle
Peron, Julie Anne
Rouaud, Tiphaine
Marchand, Annaig
Vérin, Marc
Published in Parkinsonism & related disorders. 2012, vol. 18, no. 1, p. 40-44
Abstract Background: The efficacy of continuous subcutaneous apomorphine infusion (APO) has been evaluated in advanced Parkinson's disease in several open-label studies but never in a population of patients for whom subthalamic nucleus deep brain stimulation (STN-DBS) was contraindicated. Methods: The aim of this studywas to evaluate the efficacy and cognitive safety of APO at 12-month followup in 23 advanced parkinsonian patients (mean age: 62.3 years; mean disease duration: 13.9 years)whose dopa-resistant axial motor symptoms and/or cognitive decline constituted contraindications for STN-DBS. Their motor and cognitive status were evaluated before APO and 12 months afterwards. Results: After one year, patients expressed high levels of satisfaction, with a mean rating on the Visual Analog Scale of 52.8% under APO. Daily OFF time, recorded in a 24-h diary, was reduced by 36% and ON time improved by 48%. There was a significant reduction (-26%) in mean oral levodopa equivalent dose. Dopa-resistant axial symptoms and neuropsychological performance remained stable. No adverse event was noted and none of the patients needed to take clozapine at any time. Conclusions: APO is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN-DBS is contraindicated due to dopa-resistant axial motor symptoms and/or cognitive decline. As such, it should be regarded as a viable alternative for these patients.
Keywords Parkinson's disease — Subcutaneous apomorphine infusion — Neuropsychological assessment — Axial motor symptoms
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Article (Published version) (115 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Faculté de psychologie et des sciences de l'éducation / Section de psychologie
Centres et instituts / Centre interfacultaire en sciences affectives
Research groups Affective sciences
Neuroscience de l'émotion et dynamiques affectives (NEAD)
Citation
(ISO format) 		DRAPIER, Sophie et al. Apomorphine infusion in advanced Parkinson's patients with subthalamic stimulation contraindications. In: Parkinsonism & Related Disorders, 2012, vol. 18, n° 1, p. 40-44. doi: 10.1016/j.parkreldis.2011.08.010 https://archive-ouverte.unige.ch/unige:103785

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Deposited on : 2018-04-23

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