Fluctuating functions related to quality of life in advanced Parkinson disease: effects of duodenal levodopa infusion

D Isacson, K Bingefors, Ivar Sønbø Kristiansen

Research output: Contribution to journalJournal articleResearchpeer-review


OBJECTIVE: To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy. METHODS: Of 18 patients completing a 6-week trial (DIREQT), 12 were followed for up to 6 months and assessed using electronic diaries and the PD Questionnaire-39 (PDQ-39). RESULTS: During the trial and follow-up, major diurnal fluctuations were observed, especially for hyperkinesia, 'off' time, ability to walk and depression. Duodenal infusion was associated with significantly more favourable outcomes compared with conventional treatment for satisfaction with overall functioning, 'off' time and ability to walk, with improved outcomes with PDQ-39. CONCLUSIONS: Relative to conventional treatment, infusion therapy may stabilize and significantly improve motor function and patient's QoL. The potential for daily fluctuation in PD symptoms means single measures of treatment effectiveness can result in bias in effect estimates and hence repeated measures are recommended.
Original languageEnglish
JournalActa Neurologica Scandinavica
Issue number6
Pages (from-to)379-86
Number of pages7
Publication statusPublished - 2008


  • Aged
  • Antiparkinson Agents
  • Cross-Over Studies
  • Depressive Disorder
  • Disease Progression
  • Duodenum
  • Female
  • Gait Disorders, Neurologic
  • Humans
  • Hyperkinesis
  • Levodopa
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motor Activity
  • Movement Disorders
  • Parkinson Disease
  • Patient Satisfaction
  • Quality of Life
  • Questionnaires
  • Sickness Impact Profile
  • Treatment Outcome

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