Journal of neurology · 2026
Effect of continuous subcutaneous foslevodopa/foscarbidopa infusion on gait in advanced Parkinson's disease: a real-world wearable-based study.
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Meksi Kristi, Simonetta Clara, Campone Jacopo, Ferrari Valerio, Antonucci Matteo, Conti Matteo, Schirinzi Tommaso, Centonze Diego, Avvento Francesca, Stefani Alessandro, Pierantozzi Mariangela
Аннотация
BACKGROUND: In patients with advanced Parkinson's disease (PD), spatiotemporal gait parameters and freezing of gait (FoG) show a variable responsiveness to levodopa, with FoG often exacerbated by motor fluctuations. Continuous subcutaneous foslevodopa/foscarbidopa (LDp/CDp) infusion effectively reduces motor fluctuations; however, its effects on gait remain incompletely explored.
OBJECTIVES: To provide an objective, wearable-based assessment of FoG and gait parameters during LDp/CDp infusion in patients with PD, and to investigate their association with motor fluctuations and clinical outcomes.
METHODS: PD patients were evaluated at baseline (T0), after 6 (T1) and 12 months (T2) of LDp/CDp therapy. Real-world monitoring was performed using a wearable sensor (STAT-ON) for five consecutive days at each timepoint. Wearable-derived outcomes included FoG/h, gait parameters (gait speed, step length, cadence, stride fluidity) and motor-state distribution (OFF-time, ON-time, dyskinesia). Clinical assessments included MDS-UPDRS Part III-IV, new Freezing of Gait Questionnaire (NFOG-Q) and PDQ-39.
RESULTS: FoG/h, stride fluidity, step length improved significantly over time (p = 0.017, p = 0.004, p = 0.002, respectively), alongside the reduction in OFF time (p = 0.043) and dyskinesia (p = 0.021). MDS-UPDRS Part IV, NFOG-Q, and PDQ-39 scores improved significantly in parallel. OFF-time reduction was associated with reduced FoG burden (ρ = 0.657, p = 0.011) and increased stride fluidity (ρ = - 0.741, p = 0.002). Post-hoc analyses indicated that improvements were evident at T1 and maintained at T2. LEDD remained unchanged.
CONCLUSIONS: LDp/CDp infusion is effective in improving FoG and selected gait parameters in PD, reflecting stabilization of motor fluctuations without increased dopaminergic exposure.
OBJECTIVES: To provide an objective, wearable-based assessment of FoG and gait parameters during LDp/CDp infusion in patients with PD, and to investigate their association with motor fluctuations and clinical outcomes.
METHODS: PD patients were evaluated at baseline (T0), after 6 (T1) and 12 months (T2) of LDp/CDp therapy. Real-world monitoring was performed using a wearable sensor (STAT-ON) for five consecutive days at each timepoint. Wearable-derived outcomes included FoG/h, gait parameters (gait speed, step length, cadence, stride fluidity) and motor-state distribution (OFF-time, ON-time, dyskinesia). Clinical assessments included MDS-UPDRS Part III-IV, new Freezing of Gait Questionnaire (NFOG-Q) and PDQ-39.
RESULTS: FoG/h, stride fluidity, step length improved significantly over time (p = 0.017, p = 0.004, p = 0.002, respectively), alongside the reduction in OFF time (p = 0.043) and dyskinesia (p = 0.021). MDS-UPDRS Part IV, NFOG-Q, and PDQ-39 scores improved significantly in parallel. OFF-time reduction was associated with reduced FoG burden (ρ = 0.657, p = 0.011) and increased stride fluidity (ρ = - 0.741, p = 0.002). Post-hoc analyses indicated that improvements were evident at T1 and maintained at T2. LEDD remained unchanged.
CONCLUSIONS: LDp/CDp infusion is effective in improving FoG and selected gait parameters in PD, reflecting stabilization of motor fluctuations without increased dopaminergic exposure.