Objective: Analyze the nutritional status, motor and non-motor symptoms of patients with Parkinson´s disease (PD) with second-line therapies [levodopa carbidopa intestinal gel (LCIG) and deep brain stimulation (DBS)] and their impact on the quality of life (QoL).

Background: PD is a neurodegenerative disorder characterized by progressive dopamine loss. While levodopa controls motor symptoms, long-term use leads to fluctuations and dyskinesias. Second-line therapies like LCIG and DBS help manage these complications. LCIG stabilizes motor symptoms but may affect nutrient absorption, whereas DBS improves motor function and can cause weight gain. Managing these factors could influence patients’ QoL.

Method: We studied 55 PD patients treated with LCIG (n=25) or DBS (n=30). The Nutritional status was evaluated with the MNA, Vitamin B6-B12, and albumin; motor function with UPDRS I-IV and non-motor symptoms with NMSS; cognition with MoCA; and QoL with PDQ-39. The analyses performed were one-way ANOVA, Tukey Post-Hoc, and Spearman correlation.

Results: Statistically significant differences were found: DBS group got better results than the LCIG group in nutritional status (albumin;p˂.001), motor (UPDRSI;p˂.001, UPDRSIII;p˂.039) and non-motor symptoms (NMSS;p˂.011), cognition (MoCA;p˂.027), and QoL (PDQ-39;p˂.001). In the LCIG group, 8.3% were malnourished, 45.8% were at risk of malnutrition, and 45.8% had a normal nutritional status. In the DBS group, 6.7% were malnourished, 16.7% were at risk of malnutrition, and 76.6% had a normal nutritional status. The correlation analysis showed a better nutritional status, in both groups, were related to a better motor function (UPDRS II: Rho=.504,p˂.001; III: Rho=.346,p=.025; IV: Rho=.348, p=.026), non-motor symptoms (Rho=.297,p=.005), and QoL(Rho=.427,p˂.001); the QoL decreased with disease duration (Rho=-.249,p=.021) and was related to better scores in motor symptoms (UPDRS II: Rho=.516,p˂.001; III: Rho=.447,p=.003), cognition (Rho=.306,p˂.005), and in nutritional status (Rho=.427,p˂.001).

Conclusion: Our results revealed that a better nutritional status was associated with better motor and non-motor performance, impacting PD patients’ QoL. The DBS group obtained better results than the LCIG group. In PD patients with second-line therapies, better nutritional status was associated with better performance on motor and non-motor symptoms, ultimately impacting QoL.

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Miguel Francisco Sepúlveda-Contardo, Joaquín Emilio Gay-San Martín, Diego Nicolás Vásquez-Peña, Pilar Valeria Obreque-Faundez, Karen Camila Roa-Bustos MFS-G. Impacto de los trastornos motores del habla y deglución sobre la calidad de vida de personas con enfermedad de Parkinson: una revisión sistemática de la literatura. Rev Ecuat Neurol 2023;32. https://doi.org/10.46997/revecuatneurol32100055.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/nutrition-motor-and-non-motor-symptoms-impact-on-lifes-quality-in-parkinsons-disease-in-second-line-therapies/