Use of the MNCD Classification to Monitor Clinical Stage and Response to Levodopa-Entacapone-Carbidopa Intestinal Gel Infusion in Advanced Parkinson’s Disease
2024; Multidisciplinary Digital Publishing Institute; Volume: 14; Issue: 12 Linguagem: Inglês
10.3390/brainsci14121244
ISSN2076-3425
AutoresDiego Santos‐García, Lydia López Manzanares, Inés Muro, Pablo Lorenzo‐Barreto, Erik Jesús Huánuco Casas, R. García-Ramos, Tamara Fernández Valle, Carlos Morata‐Martínez, Raquel Baviera‐Muñoz, Irene Martínez‐Torres, Ignacio Álvarez, D. Alonso-Modino, I. Legarda, María Fuensanta Valero‐García, José Andrés Suárez‐Muñoz, Juan Carlos Martínez‐Castrillo, Ana Belén Perona Moratalla, José María Salom, Esther Cubo, Caridad Valero‐Merino, Núria López Ariztegui, Pilar Sánchez Alonso, S. Novo Ponte, Emily Solano González, Raquel Martín García, Raúl Espinosa, Mar Carmona‐Abellán, Cici Feliz, Pedro Ruiz, Teresa Muñoz Ruíz, Beatriz Fernández Rodríguez, Marina Mata Álvarez‐Santullano,
Tópico(s)Botulinum Toxin and Related Neurological Disorders
ResumoBackground and objective: Staging Parkinson’s disease (PD) with a novel simple classification called MNCD, based on four axes (Motor; Non-motor; Cognition; Dependency) and five stages, correlated with disease severity, patients’ quality of life and caregivers’ strain and burden. Our aim was to apply the MNCD classification in advanced PD patients treated with device-aided therapy (DAT). Patients and Methods: A multicenter observational retrospective study of the first patients to start the levodopa-entacapone-carbidopa intestinal gel (LECIG) in Spain was performed (LECIPARK study). The MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) were collected by the neurologist at V0 (before starting LECIG) and V2 (follow-up visit). Wilcoxon’s signed rank and Marginal Homogeneity tests were applied to compare changes from V0 to V2. Results: Sixty-seven PD patients (58.2% males; 69.9 ± 9.3 years old) with a mean disease duration of 14.4 ± 6.5 years were included. The mean treatment duration (V2) was 172.9 ± 105.2 days. At V0, patients were classified as in stage 2 (35.8%), 3 (46.3%) or 4 (17.9%). The frequency of patients in stage 4 decreased to 9% at V2 (p = 0.001). The MNCD total score decreased from 6.27 ± 1.94 at V0 to 5.21 ± 2.23 (p < 0.0001). From V0 to V2, the motor (M; p < 0.0001) and non-motor symptom (N; p < 0.0001) burden decreased, and autonomy for the activities of daily living (D; p = 0.005) improved. Conclusions: The MNCD classification could be useful to classify advanced PD patients and to monitor the response to a DAT.
Referência(s)