Background. Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson’s disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms. Objective. To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation. Methods. We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson’s Disease Rating Scale before and after intestinal levodopa infusion. Results. Administration of intestinal levodopa caused improvement of FOG in the “ON” state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson’s Disease Rating Scale. The improvement was maintained for at least 12 months. Conclusions. Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

中文翻译：

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肠左旋多巴/卡比多巴输注作为帕金森病脑深部刺激后步态无反应冻结的治疗选择。

背景。由于其不可预测的性质和多因素的生理病理学，治疗冻结步态 (FOG) 始终具有挑战性。近年来已提出肠内左旋多巴输注作为其改善的有价值的选择。帕金森病 (PD) 中的 FOG 可在从未出现过步态症状的患者进行深部脑刺激后出现。客观。研究肠道左旋多巴/卡比多巴输注对接受丘脑底核深部脑刺激治疗的 PD 患者出现的无反应性 FOG 的影响。方法. 我们回顾性收集和分析了五名接受丘脑底核刺激治疗的 PD 患者的人口统计学、临床和治疗数据，这些患者出现无反应的 FOG，并接受肠道左旋多巴/卡比多巴输注作为替代疗法。FOG 是根据肠道左旋多巴输注前后统一帕金森病评定量表第 14 项的分数测量的。结果。在统一帕金森病评定量表第 14 项中，4 名患者 (80%) 肠道左旋多巴给药使 FOG 在“ON”状态下改善 2 分或更多。这种改善至少维持了12个月。结论. 对于丘脑底核深部脑刺激后产生的无反应性 FOG，肠道左旋多巴输注可能是一种有价值的治疗选择。