The Impact of Manually Controlled Portable Duodopa Pump on Levodopa Pharmacokinetics and Pharmacodynamics

Pravika, M; Jacob, Jeevamma; Paul, Joseph K.

doi:10.1109/tencon.2019.8929602

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…There are enhanced treatment options such as transdermal infusion of Levodopa [8], subcutaneous or intravenous infusion of Apomorphine [9,10], intraduodenal infusion of Duodopa [11] as well as deep brain stimulation (DBS) [12]. It is evident from the previously reported clinical studies and in-silico evaluations that a conceding equilibrium is possible between the optimum symptom relief and least side effects in intraduodenal infusion compared to the other methods in terms of bioavailability, absorption time, peak time, risk factors, and the opportunity for continuous accurate drug supply [13,14]. The beneficial effect offered by intraduodenal infusion of Duodopa demands a surgical procedure known as percutaneous endoscopic gastrostomy (PEG) [15].…”

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confidence: 99%

“…Nevertheless, the traditional open-loop PDP has certain downsides such as a precise amount of Duodopa infusion before physical activity, high protein meals and disease progression is a burden as far as the patient is concerned, even though ambulatory medical therapy has been facilitated. In this situation, an 'artificial substancianigra', known as closed-loop control of dopamine in PD, is a good remedy, which requires three basic components namely CDS, controller, and Duodopa infusion pump [14]. A subcutaneous closed-loop control of Levodopa for maintaining steady plasma Levodopa concentration has already been reported in [17].…”

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confidence: 99%

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An Automated Ambulatory Duodopa Pump: A Sliding Mode Control Approach

Malangandi

Jacob

Kunnel

2022

Preprint

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Around ten million people in the world are affected by Parkinson's disease (PD), accounting for about less than 1% of the global population. The rising prevalence of PD draws attention to the growing individual and social cost, as well as the urgent need for efforts to enhance the quality of life of the patient. The automation of the conventional ambulatory Duodopa pump (ADP) is the most challenging aspect of dopamine therapy for PD due to a range of unanticipated external events. In this regard, the goal of this paper is to develop a robust control strategy specifically, a sliding mode controller (SMC) scheme for a newly designed ADP to ensure optimal drug therapy. The proposed ADP is modeled by cascading the mathematical model of linear electromechanical actuator (EMA), drug infusing syringe pump in tandem with the dose-effect relationship of Levodopa and continuous dopamine sensor (CDS). While traditional SMC is liable to induce numerical chattering, smooth SMC (SSMC) and an integral SMC (ISMC) are designed to minimize chattering by maintaining accuracy in set-point tracking of plasma dopamine concentration. The in-silico results described in this paper persuasively confirm that the SSMC and ISMC supersede the traditional one in numerous key ways: chattering in the control input is nearly non-existent, fast-tracking performance, and good transient response. A robust stability evaluation with ISMC reveals that it can accommodate only a small cohort with less inter-patient variability, but its overall performance in terms of chattering reduction and set-point tracking is superior to that of traditional SMC and SSMC.

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