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Patients started LCIG infusion after receiving an implant of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) following a previously described procedure used in our center .
Moreover, motor fluctuations, dyskinesia, and other motor and nonmotor clinical aspects were evaluated before starting LCIG infusion (baseline) after 6 months of treatment.
The Wilcoxon signed-rank test was used for the comparison of paired samples before and after 6 months of LCIG infusion.
Dyskinesia assessed with UPDRS part IV decreased significantly from 5.4 [+ or -] 2.4 at baseline to 2.9 [+ or -] 1.1 after 6 months of LCIG treatment (P = 0.028).
As shown in Table 2, at 6 months after LCIG infusion, there was a decrease in scores of the ESS, FSS, and PSQI as compared with baseline, indicating an improvement in daytime sleepiness, fatigue, and sleep quality.
The percentage of NREM sleep increased from a mean of 83.6 [+ or -] 10.1% at baseline to 89.6 [+ or -] 6.8% after 6 months of LCIG infusion therapy, although differences did not reach statistical significance (P = 0.080) (Table 3).
In an interim analysis of the long-term study, data were analysed from 192 patients with advanced Parkinson's disease who had completed 12 weeks of treatment with LCIG for 16 hours per day.
In view of the ongoing need to audit the outcomes of the use of LCIG in a cohort of patients either unsuitable or not sufficiently helped by apomorphine and/or DBS and thus justify both the invasive nature and expense, we have examined the outcome of LCIG use in our own service, using the PDQ39 measure of quality of life and its subscores, as well as diary data regarding periods spent "On," "Off," "Asleep," and "On with LID"
All data were checked for distribution normality using the Shapiro-Wilktest and then paired t-tests used to compare baseline scores with scores at latest followup on LCIG.
A description of the 12 patients started on LCIG is presented in Table 1.
In patient 4, the NJ assessment period was prolonged to 2 weeks to properly establish whether LCIG could lead to an improvement in cognitive impairment via prolonged withdrawal of dopamine agonist medication.
Two individuals had no improvement on diary evaluation or PDQ39, of these 1 had an LRRK2 mutation and previously had responded poorly to DBS, and the other had the lowest severity of disease of the group and stopped LCIG in order to seek out "experimental disease-modifying therapies" Mean comparisons of baseline and latest follow-up scores for the diary data are presented in Table 3.
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