Therapeutic Spectrum of Intermittent Apomorphine in Parkinson’s Disease: Neuropsychiatric, Behavioral, and Cognitive Analyses
Noropsikiyatri Arsivi, cilt.63, ss.333-340, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 63
- Basım Tarihi: 2026
- Doi Numarası: 10.29399/npa.29252
- Dergi Adı: Noropsikiyatri Arsivi
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Psycinfo, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Middle East & Africa Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.333-340
- Anahtar Kelimeler: age-stratified analysis, cognitive function, intermittent subcutaneous apomorphine injection, motor fluctuations, non-motor symptoms, Parkinson’s disease
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Introduction: Intermittent subcutaneous (SC) apomorphine is a fast-acting dopamine agonist used in the management of motor fluctuations in advanced Parkinson’s disease (PD). While its motor benefits are well established the effects on non-motor domains and the modifying role of chronological age remain less certain. This prospective observational study aimed to evaluate the effectiveness of intermittent SC apomorphine on motor and non-motor outcomes in idiopathic PD patients with persistent motor fluctuations despite optimized oral therapy, and to examine whether age influenced therapeutic response. Methods: Thirty-five idiopathic PD patients treated with intermittent SC apomorphine were followed for twelve weeks and assessed at baseline and week 12. Motor outcomes included Movement Disorder Society– Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III and diary-based daily “off” and “on” time without dyskinesia. Non-motor outcomes comprised the Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Parkinson’s Disease Questionnaire (PDQ-8), and Parkinson’s Disease Sleep Scale (PDSS). Subgroup analyses compared outcomes between patients aged <45 and ≥45 years and interaction effects were explored. Results: MDS-UPDRS Part III scores improved from 45.71 (SD 11.93) to 29.86 (SD 12.24) (p <0.001). Mean daily “off” time decreased from 5.60 (1.65) to 2.26 (0.95) hours, while “on” time without dyskinesia raise from 10.34 (1.76) to 13.89 (0.93) hours (both p <0.001). Non-motor outcomes also improved: BDI declined from 23.03 (5.70) to 18.09 (4.87), MoCA increased from 15.74 (5.51) to 18.03 (6.05), and PDQ-8 from 22.80 (5.60) to 17.54 (5.84) (all p <0.001). Parkinson’s disease sleep scale showed no significant change. No significant age-by-treatment interaction effects were detected. Conclusion: Intermittent subcutaneous apomorphine was associated with significant improvements in multidimensional aspects, including motor and various non-motor domains, which are closely related to cognition, mood, and quality of life in PD. Benefits were consistent across age groups, indicating chronological age does not influence efficacy.