Levodopa-carbidopa intestinal gel (LCIG) is effective for the control of motor fluctuations in Parkinson’s disease (PD). The objective of this study is to report the reduction of dyskinesias after transitioning from 16 to 24-h/day LCIG infusion. From a cohort of 74 PD patients treated with LCIG for motor fluctuations, we identified 12 patients that were treated with 24-h per day infusion with the aim to control troublesome daytime dyskinesia. Clinical, demographic, dyskinesia rating scales were evaluated. Daytime dyskinesia was reduced in 75% (9/12) patients following treatment with 24-h therapy, including 7 who were compared with 16-h therapy and 2 that were transitioned from oral dopaminergic therapy to 24-h LCIG. Combining the data from all 12 subjects, troublesome dyskinesias were reduced during 24-h LCIG; UPDRS 4.1 (time spent with dyskinesias) mean change was −1.5 ± 0.75, p = 0.010 (Wilcoxon signed-rank test) and UPDRS 4.2 (functional impact of dyskinesias) mean change was −1.7 ± 0.90, p = 0.016, without changing their UPDRS part 3 “ON” scores (p = 0.138) or H&Y (p = 0.157). In 5 patients, improvement in dyskinesia occurred despite an overall increase in the total daily levodopa dose. None of the patients had worsening of dyskinesia after a median follow-up of 28 months. 24-h per day infusion of LCIG may be a useful strategy in the management of troublesome dyskinesias in PD patients with disabling dyskinesias resistant to attempts to optimise 16-hours per day therapy. We postulate that this may be due to a pharmacodynamic as opposed to pharmacokinetic mechanism.

左旋多巴-卡比多巴肠凝胶（LCIG）可有效控制帕金森氏病（PD）中的运动波动。这项研究的目的是报告LCIG输注从每天16小时转为每天24小时后运动障碍的减少。从74名接受LCIG治疗运动波动的PD患者中，我们确定了12名每天接受24小时输注治疗的患者，目的是控制麻烦的白天运动障碍。评估临床，人口统计学，运动障碍评定量表。在采用24小时治疗后，白天运动障碍减少了75％（9/12），其中包括7名与16小时治疗进行比较的患者和2名从口服多巴胺能治疗过渡到24小时LCIG的患者。结合来自所有12个受试者的数据，在24小时LCIG期间减少了麻烦的运动障碍。UPDRS 4。p  = 0.010（Wilcoxon符号秩检验）和UPDRS 4.2（运动障碍的功能影响）的平均变化为-1.7±0.90，p  = 0.016，而未更改其UPDRS第3部分的“ ON”分数（p  = 0.138）或H＆Y（p  = 0.157）。在5例患者中，尽管每日左旋多巴总剂量总体增加，但运动障碍仍得到改善。中位随访28个月后，没有患者出现运动障碍恶化。每天24小时输注LCIG可能是治疗PD患者的障碍性运动障碍的有用策略，这些患者对尝试优化每天16小时的治疗有抵抗力的残疾运动障碍。我们假设这可能是由于药代动力学而不是药代动力学机制。