Continuous dopaminergic stimulation (CDS)-based treatment in Parkinson's disease patients with motor complications: a systematic review and meta-analysis

Sci Rep. 2014 Aug 12:4:6027. doi: 10.1038/srep06027.

Abstract

A systematic review of the literature was conducted to identify randomized trials involving continuous dopaminergic stimulation (CDS) in PD patients with motor complications. Difference between n groups was assessed by partitioning heterogeneity and using the χ2 distribution with n-1 degrees of freedom, where n equals the number of groups. We looked for publication bias using funnel plotting, Egger's test and Begg's test. Twenty Randomized Controlled Trials (RCTs) were included. The results showed that CDS could evidently improve the Unified Parkinson's Disease Rating Scale (UPDRS) Part II (p < 0.0001), part III (P < 0.00001) and UPDRS total score (p < 0.00001). There was also a statistical discrepancy in off time reduction (p < 0.00001) and prolongation of on time (p < 0.00001) by the CDS therapy compared with control groups. Meanwhile, the results of this study showed obvious side effects in the CDS therapy compared with the placebo, especially at the expense of increased dyskinesia (23.4% vs 11.7%). The present study showed that CDS was beneficial in the treatment of PD patients with motor complications. But the incidence of the side events is more common than placebo.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Databases, Factual
  • Dopamine Agents / adverse effects
  • Dopamine Agents / therapeutic use*
  • Dyskinesias / etiology
  • Humans
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / pathology
  • Placebo Effect
  • Severity of Illness Index

Substances

  • Dopamine Agents