Long-term effects of intrajejunal levodopa infusion on sleep in people with advanced Parkinson's disease

Front Neurol. 2023 Apr 20:14:1105650. doi: 10.3389/fneur.2023.1105650. eCollection 2023.

Abstract

Background: Sleep disturbances are commonly encountered in people with advanced Parkinson's disease (PD). In these stages, levodopa-carbidopa intestinal gel (LCIG) is recommended for improving motor symptoms, some non-motor dysfunctions, and quality of life in these patients. This study aimed to assess the effects of LCIG on sleep in PD in a longitudinal study.

Study design: An open-label observational study in patients with advanced PD undergoing LCIG treatment was carried out.

Measures and outcomes: In total, 10 consecutive advanced people with PD were evaluated at the baseline and after 6 months and 1 year, respectively, of LCIG infusion. Sleep parameters were assessed with several validated scales. We assessed the evolution of sleep parameters under LCIG infusion over time and the effects on sleep quality.

Results: Significant improvement following LCIG was observed in PSQI total score (p = 0.007), SCOPA-SLEEP total score (p = 0.008), SCOPA-NS subscale (p = 0.007), and AIS total score (p = 0.001) at 6 months and 1 year, compared to the baseline. The PSQI total score at 6 months correlated significantly with the Parkinson's Disease Sleep Scale, version 2 (PDSS-2) "disturbed sleep" item at 6 months (p = 0.28; R = 0.688), while the PSQI total score at 12 months significantly correlated with the PDSS-2 total score at 1 year (p = 0.025, R = 0.697) and with the AIS total score at 1 year (p = 0.015, R = 0.739).

Conclusion: LCIG infusion demonstrated beneficial effects on sleep parameters and sleep quality, which were constant over time for up to 12 months.

Keywords: advanced Parkinson's disease; insomnia; intrajejunal levodopa infusion; longitudinal; sleep.