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Review
. 2013 Nov;260(11):2701-14.
doi: 10.1007/s00415-012-6798-6. Epub 2013 Jan 5.

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

Jens Volkmann  1 , 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
Affiliations
Review

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

Jens Volkmann et al. J Neurol. 2013 Nov.

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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References

    1. Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F. Impact of the motor complications of Parkinson’s disease on the quality of life. Mov Disord. 2005;20(2):224–230. doi: 10.1002/mds.20279. - DOI - PubMed
    1. Calne SM. The psychosocial impact of late-stage Parkinson’s disease. J Neurosci Nurs. 2003;35:306–313. doi: 10.1097/01376517-200312000-00004. - DOI - PubMed
    1. Lökk J. Reduced life-space of non-professional caregivers to Parkinson’s disease patients with increased disease duration. Clin Neurol Neurosurg. 2009;111(7):583–587. doi: 10.1016/j.clineuro.2009.05.011. - DOI - PubMed
    1. Brainin M, Barnes M, Baron J-C, Gilhus NE, Hughes S, Selmaj K, Waldemar G. Guidance for the preparation of neurological management guidelines by EFNS scientific task forces—revised recommendations 2004. Eur J Neurol. 2004;11:577–581. doi: 10.1111/j.1468-1331.2004.00867.x. - DOI - PubMed
    1. Follett K, Weaver F, Stern M, Hur K, Harris CL, Luo P, et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson’s disease. N Engl J Med. 2010;362(22):2077–2091. doi: 10.1056/NEJMoa0907083. - DOI - PubMed

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