Scholarlink

Background <p>In patients with advanced Parkinson’s disease (PD), spatiotemporal gait parameters and freezing of gait (FoG) show a variable responsiveness to levodopa, with FoG often exacerbated by motor fluctuations. Continuous subcutaneous foslevodopa/foscarbidopa (LDp/CDp) infusion effectively reduces motor fluctuations; however, its effects on gait remain incompletely explored.</p> Objectives <p>To provide an objective, wearable-based assessment of FoG and gait parameters during LDp/CDp infusion in patients with PD, and to investigate their association with motor fluctuations and clinical outcomes.</p> Methods <p>PD patients were evaluated at baseline (T0), after 6 (T1) and 12&#xa0;months (T2) of LDp/CDp therapy. Real-world monitoring was performed using a wearable sensor (STAT-ON) for five consecutive days at each timepoint. Wearable-derived outcomes included FoG/h, gait parameters (gait speed, step length, cadence, stride fluidity) and motor-state distribution (OFF-time, ON-time, dyskinesia). Clinical assessments included MDS-UPDRS Part III-IV, new Freezing of Gait Questionnaire (NFOG-Q) and PDQ-39.</p> Results <p>FoG/h, stride fluidity, step length improved significantly over time (<i>p</i> = 0.017, <i>p</i> = 0.004, <i>p</i> = 0.002, respectively), alongside the reduction in OFF time (<i>p</i> = 0.043) and dyskinesia (<i>p</i> = 0.021). MDS-UPDRS Part IV, NFOG-Q, and PDQ-39 scores improved significantly in parallel. OFF-time reduction was associated with reduced FoG burden (<i>ρ</i> = 0.657, <i>p</i> = 0.011) and increased stride fluidity (<i>ρ</i> = − 0.741, <i>p</i> = 0.002). Post-hoc analyses indicated that improvements were evident at T1 and maintained at T2. LEDD remained unchanged.</p> Conclusions <p>LDp/CDp infusion is effective in improving FoG and selected gait parameters in PD, reflecting stabilization of motor fluctuations without increased dopaminergic exposure.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effect of continuous subcutaneous foslevodopa/foscarbidopa infusion on gait in advanced Parkinson’s disease: a real-world wearable-based study

  • 期刊论文

  • 发表日期：

    2026年7月22日

查看全文
  • Kristi Meksi,
  • Clara Simonetta,
  • Jacopo Campone,
  • Valerio Ferrari,
  • Matteo Antonucci,
  • Matteo Conti,
  • Tommaso Schirinzi,
  • Diego Centonze,
  • Francesca Avvento,
  • Alessandro Stefani,
  • Mariangela Pierantozzi

摘要

Background

In patients with advanced Parkinson’s disease (PD), spatiotemporal gait parameters and freezing of gait (FoG) show a variable responsiveness to levodopa, with FoG often exacerbated by motor fluctuations. Continuous subcutaneous foslevodopa/foscarbidopa (LDp/CDp) infusion effectively reduces motor fluctuations; however, its effects on gait remain incompletely explored.

Objectives

To provide an objective, wearable-based assessment of FoG and gait parameters during LDp/CDp infusion in patients with PD, and to investigate their association with motor fluctuations and clinical outcomes.

Methods

PD patients were evaluated at baseline (T0), after 6 (T1) and 12 months (T2) of LDp/CDp therapy. Real-world monitoring was performed using a wearable sensor (STAT-ON) for five consecutive days at each timepoint. Wearable-derived outcomes included FoG/h, gait parameters (gait speed, step length, cadence, stride fluidity) and motor-state distribution (OFF-time, ON-time, dyskinesia). Clinical assessments included MDS-UPDRS Part III-IV, new Freezing of Gait Questionnaire (NFOG-Q) and PDQ-39.

Results

FoG/h, stride fluidity, step length improved significantly over time (p = 0.017, p = 0.004, p = 0.002, respectively), alongside the reduction in OFF time (p = 0.043) and dyskinesia (p = 0.021). MDS-UPDRS Part IV, NFOG-Q, and PDQ-39 scores improved significantly in parallel. OFF-time reduction was associated with reduced FoG burden (ρ = 0.657, p = 0.011) and increased stride fluidity (ρ = − 0.741, p = 0.002). Post-hoc analyses indicated that improvements were evident at T1 and maintained at T2. LEDD remained unchanged.

Conclusions

LDp/CDp infusion is effective in improving FoG and selected gait parameters in PD, reflecting stabilization of motor fluctuations without increased dopaminergic exposure.