{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:12:38Z","timestamp":1778645558719,"version":"3.51.4"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004704","name":"National Research Council of Thailand","doi-asserted-by":"publisher","award":["N42A680591, N35E680087"],"award-info":[{"award-number":["N42A680591, N35E680087"]}],"id":[{"id":"10.13039\/501100004704","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004776","name":"Faculty of Medicine, Chulalongkorn University","doi-asserted-by":"publisher","award":["CE68_028_3000_004"],"award-info":[{"award-number":["CE68_028_3000_004"]}],"id":[{"id":"10.13039\/501100004776","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004776","name":"Faculty of Medicine, Chulalongkorn University","doi-asserted-by":"publisher","award":["Ratchadapiseksompotch Fund, RA-MF-22\/69"],"award-info":[{"award-number":["Ratchadapiseksompotch Fund, RA-MF-22\/69"]}],"id":[{"id":"10.13039\/501100004776","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017170","name":"Thailand Science Research and Innovation","doi-asserted-by":"publisher","award":["Programme Management Unit for Competitiveness: C01"],"award-info":[{"award-number":["Programme Management Unit for Competitiveness: C01"]}],"id":[{"id":"10.13039\/501100017170","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Economic and Social Development Council of Thailand"},{"DOI":"10.13039\/100015396","name":"Thailand Center of Excellence for Life Sciences","doi-asserted-by":"publisher","award":["TC (ERP) 31\/2568"],"award-info":[{"award-number":["TC (ERP) 31\/2568"]}],"id":[{"id":"10.13039\/100015396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with Parkinson\u2019s disease (PD) receiving device-aided therapies (DATs) frequently experience vitamin B depletion and nutritional challenges. However, the effects of continuous subcutaneous apomorphine infusion (CSAI) on vitamin B status and nutritional outcomes in advanced PD remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the clinical effectiveness of CSAI and associated changes in vitamin B status, homocysteine (Hcy) levels and nutritional outcomes in patients with advanced PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A prospective observational cohort study in a single centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Thirty patients with advanced PD were enrolled between January 2023 and March 2025. Clinical, biochemical and nutritional assessments were performed at baseline and after 3\u2009months. Motor outcomes included daily OFF hours, dyskinesia hours, Hoehn and Yahr stage and the Unified PD Rating Scale (UPDRS). Biochemical measures comprised serum vitamins B\n                      <jats:sub>1<\/jats:sub>\n                      , B\n                      <jats:sub>6<\/jats:sub>\n                      , B\n                      <jats:sub>12<\/jats:sub>\n                      , folate and plasma Hcy levels. Nutritional status was assessed using body weight, body mass index (BMI) and the Mini Nutritional Assessment\u2013Short Form (MNA-SF).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty participants (mean age 68.5\u2009\u00b1\u20099.2\u2009years; disease duration 12.0\u2009\u00b1\u20093.9\u2009years; Hoehn &amp; Yahr 3.7\u2009\u00b1\u20090.7) completed follow-up. After 3\u2009months of CSAI, daily OFF hours, dyskinesia hours and UPDRS Part 4 scores decreased significantly (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for all). The oral levodopa daily dose was significantly reduced (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Serum vitamin B\n                      <jats:sub>1<\/jats:sub>\n                      and B\n                      <jats:sub>12<\/jats:sub>\n                      levels increased significantly, while Hcy levels showed a modest but significant reduction (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Body weight, BMI and total MNA-SF score remained unchanged (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). However, MNA-SF categories shifted toward improved nutritional classification (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.008). Adjunctive antiparkinsonian medications were significantly reduced, while levodopa remained universally prescribed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>CSAI significantly reduced motor complications and oral levodopa exposure. Secondary analyses showed selective biochemical improvements with stable overall nutritional status. Findings should be interpreted considering the observational design, lack of control group and short follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864261446737","type":"journal-article","created":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T09:02:37Z","timestamp":1778403757000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biochemical and nutritional changes during continuous subcutaneous apomorphine infusion in advanced Parkinson\u2019s disease: findings from an observational cohort"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0060-9935","authenticated-orcid":false,"given":"Onanong","family":"Phokaewvarangkul","sequence":"first","affiliation":[{"name":"Chulalongkorn Centre of Excellence for Parkinson\u2019s Disease &amp; Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naruemon","family":"Rattanapitak","sequence":"additional","affiliation":[{"name":"Chulalongkorn Centre of Excellence for Parkinson\u2019s Disease &amp; Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panthitra","family":"Kuwattanasuchati","sequence":"additional","affiliation":[{"name":"Chulalongkorn Centre of Excellence for Parkinson\u2019s Disease &amp; Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-2064","authenticated-orcid":false,"given":"Roongroj","family":"Bhidayasiri","sequence":"additional","affiliation":[{"name":"Chulalongkorn Centre of Excellence for Parkinson\u2019s Disease &amp; Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Bangkok 10330, Thailand The Academy of Science, The Royal Society of Thailand, Bangkok 10210, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-023-02684-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-025-02935-x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00007-1"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-023-00541-w"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(01)00126-3"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2023.105357"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22607"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-025-02893-4"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.53.11.1004"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2025.107923"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.12.024"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13810"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-024-02782-2"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1502165"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30239-4"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-023-02609-6"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2021.09.022"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1877718X241310727"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-023-02666-x"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.12.003"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000361"},{"key":"e_1_3_4_23_2","unstructured":"Phokaewvarangkul O Kantachadvanich N Bhidayasiri R. 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