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Open Access 01-11-2013 | Review

Selecting deep brain stimulation or infusion therapies in advanced Parkinson’s disease: an evidence-based review

Authors: Jens Volkmann, Alberto Albanese, Angelo Antonini, K. Ray Chaudhuri, Carl E. Clarke, Rob M. A. de Bie, Günther Deuschl, Karla Eggert, Jean-Luc Houeto, Jaime Kulisevsky, Dag Nyholm, Per Odin, Karen Østergaard, Werner Poewe, Pierre Pollak, Jose Martin Rabey, Olivier Rascol, Evzen Ruzicka, Michael Samuel, Hans Speelman, Olof Sydow, Francesc Valldeoriola, Chris van der Linden, Wolfgang Oertel

Published in: Journal of Neurology | Issue 11/2013

Abstract

Motor complications in Parkinson’s disease (PD) result from the short half-life and irregular plasma fluctuations of oral levodopa. When strategies of providing more continuous dopaminergic stimulation by adjusting oral medication fail, patients may be candidates for one of three device-aided therapies: deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion, or continuous duodenal/jejunal levodopa/carbidopa pump infusion (DLI). These therapies differ in their invasiveness, side-effect profile, and the need for nursing care. So far, very few comparative studies have evaluated the efficacy of the three device-aided therapies for specific motor problems in advanced PD. As a result, neurologists currently lack guidance as to which therapy could be most appropriate for a particular PD patient. A group of experts knowledgeable in all three therapies reviewed the currently available literature for each treatment and identified variables of clinical relevance for choosing one of the three options such as type of motor problems, age, and cognitive and psychiatric status. For each scenario, pragmatic and (if available) evidence-based recommendations are provided as to which patients could be candidates for either DBS, DLI, or subcutaneous apomorphine.

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Title: Selecting deep brain stimulation or infusion therapies in advanced Parkinson’s disease: an evidence-based review
Authors: Jens Volkmann
Alberto Albanese
Angelo Antonini
K. Ray Chaudhuri
Carl E. Clarke
Rob M. A. de Bie
Günther Deuschl
Karla Eggert
Jean-Luc Houeto
Jaime Kulisevsky
Dag Nyholm
Per Odin
Karen Østergaard
Werner Poewe
Pierre Pollak
Jose Martin Rabey
Olivier Rascol
Evzen Ruzicka
Michael Samuel
Hans Speelman
Olof Sydow
Francesc Valldeoriola
Chris van der Linden
Wolfgang Oertel
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 11/2013
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-012-6798-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Selecting deep brain stimulation or infusion therapies in advanced Parkinson’s disease: an evidence-based review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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