Living with Parkinson’s individual. The potential benefits of DBS must intestine through a tube — a type of admin- istration intended to bypass the stomach. A small infusion pump administers the drug continuously over 16 hours. In clinical trials, use of Duopa led to two fewer hours of “off time” than treatment with immediate-release, oral carbidopa/levodopa pills (i.e., Sinemet). be balanced against potential risks, including stroke, bleeding and infection. In people with cognitive problems, DBS could worsen symptoms. Hear about one patient’s experience with DBS at michaeljfox.org/PD360. Duopa represents a promising new option in treating PD, especially for those in later stages of the disease. With that said, no treatment is perfect. Duopa requires that patients wear a large, external “box” in the belt region and caregivers must help to manage the device, tend to the skin where the tube enters the body and facilitate medication refills. In early studies, people experienced device-related problems with the intestinal tube, which can clog, bend or move out of position. ABOUT DUOPA In the advanced stages of Parkinson’s disease, patients may begin to experience “off” time, or periods of poor mobility, slowness and stiffness. Additionally, emptying of the stomach can become delayed and unpredictable, which can affect when orally administered medicines are absorbed in the small intestine. Duopa is delivered directly into the small The Latest “Ask the MD” Resources Rachel Dolhun, MD, addresses popular Parkinson’s topics and translates the latest research in blog posts and videos. www.michaeljfox.org/ask-the-md Z Z Z SLEEP DISTURBANCES IN PARKINSON’S This common non-motor symptom — including difficulty falling asleep, staying asleep or both — can occur due to a variety of factors. YOUNG-ONSET PARKINSON’S DISEASE (YOPD) People with YOPD (diagnosis at age 50 or earlier) can experience certain symptoms differently and may take alter- nate approaches to management of the disease. PAIN AND PARKINSON’S DISEASE Pain is a common, but perhaps unexpected, non-motor symptom of PD. It is unfortunately often under- recognized and therefore undertreated. 13 Spring/Summer 2017 COGNITIVE IMPAIRMENT AND PD Mild cognitive impairment may cause difficulty with “executive functions,” such as multitasking, concentrating and problem solving. DEPRESSION AND ANXIETY IN PARKINSON’S Depression and anxiety can be experienced after a diagnosis or while adjusting to changing symptoms, but they are also a part of the underlying disease itself.