Multiple logistic regression analysis of respondents’ characteristics and anxiety.

<p>Multiple logistic regression analysis of respondents’ characteristics and anxiety.</p

Respondents’ characteristics by depression, anxiety and stress status.

<p>Respondents’ characteristics by depression, anxiety and stress status.</p

Multiple logistic regression analysis of respondents’ characteristics and stress.

<p>Multiple logistic regression analysis of respondents’ characteristics and stress.</p

Mental health status of the elderly respondents: scores of Dass-21 subscales.

<p>Mental health status of the elderly respondents: scores of Dass-21 subscales.</p

Eradication of <i>Helicobacter pylori</i> Infection Improves Levodopa Action, Clinical Symptoms and Quality of Life in Patients with Parkinson's Disease

<div><p>Background</p><p>Previous studies have demonstrated a higher prevalence of <i>Helicobacter pylori (H. pylori)</i> infection in patients with Parkinson's disease (PD) compared to controls. <i>H. pylori</i> infection affects levodopa absorption and its eradication significantly improves clinical response to levodopa. Here, we studied the prevalence of <i>H. pylori</i> infection and its eradication effects among our PD patients.</p><p>Methods</p><p>A prospective study involving idiopathic PD patients on levodopa therapy. ¹³C-urea breath test (UBT) was used to detect <i>H. pylori</i>. UBT-positive patients were given standard eradication therapy and followed up at 6 and 12 weeks in an open label single arm design. Repeat UBT was performed at 12 weeks. The UPDRS, PD NMQ, PD NMSS and PDQ-39 were administered at baseline and post-eradication (6 and 12 weeks). Levodopa ‘onset’ time and ON-duration were recorded.</p><p>Results</p><p>Of 82 patients recruited, 27 (32.9%) had positive UBT. <i>H. pylori</i>-positive patients had significantly poorer total UPDRS (p = 0.005) and PDQ39 (p<0.0001) scores compared to <i>H. pylori</i>-negative patients. At 12 weeks post-eradication, the mean levodopa onset time shortened by 14 minutes (p = 0.011). The mean ON duration time increased by 56 minutes at week 6 (p = 0.041) and 38 minutes at week 12 (p = 0.035). The total UPDRS scores (p<0.0001), scores for parts II (p = 0.001), III (p<0.0001) and IV (p = 0.009) were significantly better. The total PDQ-39 scores (p = 0.001) and subdomains mobility (p = 0.002), ADL (p = 0.001), emotional well being (p = 0.026) and stigma (p = 0.034) significantly improved. The PD NMSQ did not show significant improvement.</p><p>Conclusions</p><p><i>H. pylori</i> eradication improved levodopa onset time, ON duration, motor severity and quality of life parameters. Screening and eradication of <i>H. pylori</i> is inexpensive and should be recommended in PD patients, particularly those with erratic response to levodopa.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02112812" target="_blank">NCT02112812</a></p></div

Study Flow Chart.

<p>Study Flow Chart.</p

Clinical Effects at baseline and following <i>H. pylori</i> eradication therapy (n = 21).

<p>All analyses were performed using ANOVA.</p><p>Clinical Effects at baseline and following <i>H. pylori</i> eradication therapy (n = 21).</p