Evaluation of the Nonmotor Symptomatology of Parkinsonian Patients Treated With Two Strategies Related to Apomorphine Pump Therapy in French Hospitals

• Change in the Parkinson's Disease Quality of Life Questionnaire (PDQ39) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  Scale to evaluate the Quality of life
• Change in the Neurologist Global Impression of change (CGI) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  Scale to evaluate the Quality of life
• Change in non-motor aspects of experiences of daily living (MDS-UPDRS I) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in apathy assessed on the long version of Lille Apathy Rating Scale between the Baseline assessment and the assessment at 6 months' follow up (LARS)[ Time Frame: 6 months ]
• Change in occurrence of anxiety (STAI-YA) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  Present feelings
• Change in occurrence of anxiety (STAI-YB) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  General feelings
• Change in behavioral symptoms assessed by Ardouin Scale between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in emotional function assessed by the short form of the TEIQue between the Baseline assessment and the assessment at 6 months' follow upscale[ Time Frame: 6 months ]
  Trait Emotional Intelligence Questionnaire (TEIQue )
• Change in emotional function assessed by the short form of the BEQ scale between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  Berkeley's Expressivity Questionnaire (BEQ)
• Change in motor aspects of experiences of daily in "on" and "off" medication (MDS-UPDRS II) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in motor examination during "on" periods (MDS-UPDRS III) between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in motor complications with MDS-UPDRS IV between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in motor examination with the Schwab and England scale between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Change in motor examination with the Hoehn & Yarr scale[ Time Frame: 6 months ]
• Change in cognitive function assessed by the MoCA scale between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
  Montreal Cognitive Assessment (MoCA)
• Change of dose for treatments assessed by levodopa (L-DOPA) équivalents between the Baseline assessment and the assessment at 6 months' follow up[ Time Frame: 6 months ]
• Frequency, type and severity of therapy-related adverse events[ Time Frame: 6 months ]

There is currently no consensus on the adequate concomitant treatment to apomorphine pump in Parkinson's disease (PD). In practice, some centers withdraw all dopaminergic agonists when initiating apomorphine pump therapy, whereas others combine the two. To date, there has been no study led to determine the best strategy for efficiently treating motor and nonmotor symptoms, as well as improving patients' quality of life (QoL). This preliminary study, entitled AGAPO, aims at identifying significant differences in patients' evolution (nonmotor symptoms and quality of life), over a course of 6 months, depending on the two strategies adopted in French centers (apomorphine pump with or without dopaminergic agonists), through the Non Motor Symptoms Scale (NMSS, Chaudhuri et al, 2017).

• Drug: Apomorphine
  Apomorphine (5 mg/ml), supplied as solution for infusion in a 10 ml glass ampoule Hourly flow rate adjusted during the whole duration of the study to obtain the best effect in each patient
• Drug: Dopaminergic Agonist + Apomorphine
  Apomorphine (5 mg/ml), supplied as solution for infusion in a 10 ml glass ampoule Hourly flow rate adjusted during the whole duration of the study to obtain the best effect in each patient and associated with dopaminergic agonists

• Other: Apomorphine
  Withdrawal of dopaminergic agonists at pump initiation
• Other: Dopaminergic Agonist + Apomorphine
  Continuation of dopaminergic agonists at pump initiation