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12-month results from a novel test battery used in a duodenal levodopa infusion trial
Dalarna University, School of Technology and Business Studies, Computer Engineering.ORCID iD: 0000-0003-0403-338X
Dalarna University, School of Technology and Business Studies, Computer Engineering.ORCID iD: 0000-0002-2372-4226
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2010 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 17, no s3, 21-21 p.Article in journal (Refereed) Published
Abstract [en]

A novel test battery consisting of self-assessments and motor tests (tapping and spiral drawing) for patients with Parkinson’s disease (PD) was developed for a hand computer with touch screen in a telemedicine setting. Tests are performed four times per day in the home environment during weeklong test periods. Results are processed into scores for different dimensions of the symptom state and an ‘overall score’ reflecting the global condition of a patient during a test period. The test battery was validated in a separate study recently submitted to Mov Disord. This test battery is currently being used in an open longitudinal trial (DAPHNE, EudraCT No. 2005- 002654-21) by sixty-five patients with advanced PD at nine clinics around Sweden. On inclusion, the patients were either receiving treatment with duodenal levodopa/carbidopa infusion (Duodopa®) (n=36), or they were candidates for receiving this treatment (n=29). We now present interim results for the first twelve months. Test periods were performed in three-month intervals. During most of the periods, UPDRS ratings were performed in afternoons at the start of the week. In twenty of the patients, scores were available during individually optimized oral polypharamacy, before receiving infusion and at least one test period after having started infusion treatment. Usability and compliance with performing tests, this far are good, both with patients and clinical staff. Correlations between test periods 2 and 3 during infusion treatment (three months apart) are stronger for overall test score than for total UPDRS, indicating good reliability. The correlation between overall test score and UPDRS for all test periods is adequate (r=-0.6). In an exact Wilcoxon signed rank test, where the endpoint is the change from the first to the twelve month test period (n=25), there was no change in test results in any of the test battery dimensions for the patients already receiving infusion when included. However, in the patients entering the study before receiving infusion, there was a significant change (improvement) from the baseline to the twelve month test period in dimensions; ‘off’, ‘dyskinesia’ and ‘satisfied’ and in the ‘overall score’ (n=15). The mean improvement in overall score after infusion was 29% (p=0.015). We conclude that the test battery is able to measure a functional improvement with infusion that is sustained over at least twelve months.

Place, publisher, year, edition, pages
Buenos Aires, 2010. Vol. 17, no s3, 21-21 p.
National Category
Clinical Medicine
Research subject
Komplexa system - mikrodataanalys, E-MOTIONS, Beslutsstöd för Parkinsonbehandling
Identifiers
URN: urn:nbn:se:du-4854ISI: 000293331100044OAI: oai:dalea.du.se:4854DiVA: diva2:522145
Conference
The Movement Disorder Society's 14th International Congress of Parkinson's Disease and Movement Disorders, Buenos Aires, 13-17 juni, 2010
Available from: 2010-06-22 Created: 2010-06-22 Last updated: 2015-06-12Bibliographically approved

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CiteExportLink to record
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