[Device-aided therapies in advanced Parkinson's disease]

Area of Science:

• Neurology
• Neuroscience
• Movement Disorders

Background:

• Advanced Parkinson's disease (PD) presents motor fluctuations and dyskinesia.
• Oral and transdermal medications are often inadequate for symptom control in advanced PD.
• Non-motor symptoms also worsen in advanced stages.

Purpose of the Study:

• To review the efficacy and safety of device-aided therapies for advanced Parkinson's disease.
• To guide the selection of appropriate device-aided therapies based on patient-specific factors.
• To compare deep brain stimulation (DBS), duodopa, and apomorphine infusion therapies.

Main Methods:

• Literature review of existing data on device-aided therapies for advanced PD.
• Analysis of factors influencing the choice of therapy, including motor and non-motor symptoms.
• Consideration of patient age, disease duration, comorbidities, and social support.

Main Results:

• Deep brain stimulation (DBS), intrajejunal duodopa infusion, and subcutaneous apomorphine infusion are effective options for advanced PD.
• Each therapy has unique characteristics impacting efficacy and safety.
• Individual patient profiles significantly influence the optimal choice of device-aided therapy.

Conclusions:

• Device-aided therapies are crucial for managing advanced Parkinson's disease when conventional treatments fail.
• The selection of DBS, duodopa, or apomorphine requires careful consideration of disease severity and patient-specific variables.
• Personalized treatment strategies are essential for improving quality of life in advanced PD patients.