Objective: To evaluate the frequency of motor fluctuations in patients with Parkinson’s disease and to study the effectiveness of methods modifying the course of the disease.

Background: Motor fluctuations, a serious complication of levodopa therapy in Parkinson’s disease, arise as its efficacy diminishes over time. While levodopa remains effective long-term, prolonged use reduces therapeutic benefits. Dyskinesias develop in 50-80% of patients after 5-7 years and nearly all patients after 15-20 years of treatment.

Method: The study was conducted on the basis of the Republican Neurological Centre

The age of the patients ranged from 45-75 years. All patients with motor fluctuations were prescribed combination therapy with Dopalevo (levodopa 200 mg + carbidopa 25 mg + entacapone 200 mg), previously these patients were taking Nacom ( levodopa 250 + carbidopa 25 mg). In addition, patients were advised to limit their intake of protein-containing foods while taking the drug to optimise its efficacy.

Results: Among 37 patients with Parkinson’s disease hospitalised, 8 had motor fluctuations. All these patients were receiving antiparkinsonian therapy including levodopa or the combination drug Nacom (levodopa + carbidopa). During the period of hospitalisation, they were prescribed therapy with Dopalevo. In patients with motor fluctuations, 5 patients started the disease at an earlier age (under 50 years), and the mean duration of the disease was 10 ± 2.5 years. These patients also had more severe non-motor manifestations, including depression and anxiety disorders. On the background of adding entacapone to the therapy scheme all patients with motor fluctuations showed improvement of motor indices according to UPDRS scale. A tendency to increase the duration of the ‘on’ period and to reduce the ‘off’ period was revealed. In addition, there was a gradual decrease in the daily dose of levodopa, which may indicate an increase in the efficacy of antiparkinsonian therapy.

Conclusion: Motor fluctuations in Parkinson’s disease lead to a decrease in the functional status of patients, having a significant impact on their quality of life. Most often these motor disturbances are observed in patients with earlier disease debut. Inclusion of entacapone in the antiparkinsonian therapy regimen promotes improvement of motor functions, which may contribute to the overall effectiveness of treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-fluctuations-in-parkinsons-disease-and-their-correction/