caa a22 4500 44580954X CHVBK 20180317145207.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00415-010-5793-z doi (NATIONALLICENCE)springer-10.1007/s00415-010-5793-z A 5-year prospective assessment of advanced Parkinson disease patients treated with subcutaneous apomorphine infusion or deep brain stimulation [Elektronische Daten] [Angelo Antonini, Ioannis Isaias, Giorgia Rodolfi, Andrea Landi, Francesca Natuzzi, Chiara Siri, Gianni Pezzoli] Prospective comparative long-term data on the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and continuous subcutaneous infusion of apomorphine (CSAI) in patients with advanced Parkinson disease (PD) are lacking. We report 5-year follow-up of 25 PD patients treated with either STN-DBS (n=13) or CSAI (n=12) who fulfilled CAPSIT-PD criteria. Cohorts were matched for disease duration and severity of motor complications. Baseline clinical and neuropsychological status did not differ among cohorts. Patients were assessed with the UPDRS, MMSE, HAMD-17 and Neuropsychiatric Inventory (NPI).Twelve subjects reached the 5-year follow-up with STN-DBS (one was lost at follow-up) versus two in the CSAI cohort. Drop-outs with CSAI were due to subcutaneous nodules (n=2), insufficient control of motor fluctuations and dyskinesia (n=4), death for unrelated reasons (n=3) and one was lost at follow-up. Average apomorphine dose at last visit was 83.4±19.2mg/day and average treatment duration was 30months. At 1-year as well as at last follow-up (intention-to-treat analysis), both therapies decreased daily off-time but only STN-DBS reduced dyskinesia duration and severity. Decrement of medications was greater with STN-DBS. There was a significant worsening of NPI after STN-DBS, primarily because four subjects developed apathy. Springer-Verlag, 2010 Apomorphine nationallicence Deep brain stimulation nationallicence Parkinson disease nationallicence CF : Category fluency nationallicence CPM : Raven's Colored Progressive Matrices nationallicence CSAI : Continuous subcutaneous apomorphine infusion nationallicence CVLT : California Verbal Learning Test nationallicence HAMD-17 : Hamilton Depression Rating Scale-17 nationallicence H&Y : Hoehn and Yahr nationallicence MMSE : Mini-Mental State Examination nationallicence NPI : Neuropsychiatric Inventory nationallicence PF : Phonemic fluency nationallicence PWL : Paired Word Learning nationallicence STN-DBS : Subthalamic nucleus-deep brain stimulation nationallicence UPDRS : Unified Parkinson Disease Rating Scale nationallicence Antonini Angelo Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Isaias Ioannis Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Rodolfi Giorgia Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Landi Andrea Department of Neurosurgery, Ospedale San Gerardo, University of Milano Bicocca, Monza, Italy aut Natuzzi Francesca Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Siri Chiara Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Pezzoli Gianni Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut Journal of Neurology Springer-Verlag 258/4(2011-04-01), 579-585 0340-5354 258:4<579 2011 258 415 https://doi.org/10.1007/s00415-010-5793-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5793-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Antonini Angelo Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 700 1- Isaias Ioannis Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 700 1- Rodolfi Giorgia Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 700 1- Landi Andrea Department of Neurosurgery, Ospedale San Gerardo, University of Milano Bicocca, Monza, Italy aut NATIONALLICENCE 700 1- Natuzzi Francesca Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 700 1- Siri Chiara Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 700 1- Pezzoli Gianni Parkinson Institute, Istituti Clinici di Perfezionamento, Via Bignami, 1, 20126, Milan, Italy aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/4(2011-04-01), 579-585 0340-5354 258:4<579 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer