Objective: The aim of the present study was to investigate the influence of apomorphine pump in Parkinson’s disease (PD) on motor and nonmotor symptoms, including in the cognitive and psychologic/psychiatric domains as well as on quality of life, specifically in patients without cognitive impairment

Background: The continuous subcutaneous apomorphine infusion in PD is an effective treatment able to control motor fluctuations and known to be cognitively safe in advanced patients. However, very few studies have investigated the influence of this treatment in the cognitive and psychologic/psychiatric domains in addition to the motor aspects, in patients without cognitive deterioration

Methods: 22 PD patients without cognitive impairment, according to the abbreviate (level 1) Movement Disorders Society guidelines, were assessed before and after 6 months of add-on apomorphine pump using motor, executive, apathy, anxiety, depression and quality of life scales

Results: At 6 months, motor fluctuations (UPDRS IV) and oral treatments were reduced significantly. Cognition was preserved despite a potential cognitive slowdown observed in the Stroop Word part, which was not observed with the others tests (Trail Making Test Part A, Stroop Color Part). Apathy, depression and anxiety did not significantly change. Finally, the quality of life scales showed significant improvement in the physical (bodily pain, bodily discomfort) and the psychological (emotional well-being) domains. In addition, we observed a trend towards an improvement in both physical health limitations and social functioning scores

Conclusions: Totally, cognitively intact PD patients appear to have benefited from 6 months of add-on apomorphine pump. This benefit concerned both the physical and the psychological aspects. Motor fluctuations were reduced, pain was less disturbing and the bodily discomforts were decreased. Concerning the psychological aspects, apathy, anxiety and depression were stable. Importantly, the emotional well-being was better and the social relationship tended to increase. Finally, as expected no important cognitive changes were observed. Thus, continuous subcutaneous apomorphine infusion therapy appears to be very efficient in patients without cognitive deterioration. It would be interesting to estimate if this better quality of life reduces the caregiver burden often associated with PD

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-continuous-apomorphine-infusion-on-motor-and-nonmotor-symptoms-in-parkinsons-disease-without-cognitive-deterioration/