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Updated: Jul 14, 2026
23:53
Ole Isacson: Development of New Therapies for Parkinson's Disease
Published on: April 29, 2007
[Second-line treatments for Parkinson's disease]
Guillaume Carey1, Luc Defebvre2
1Service de neurologie, centre expert Parkinson, hôpital Robert-Debré, CHU de Reims, Reims, France.
La Revue Du Praticien
|July 13, 2026
Summary
For advanced Parkinson's disease, when oral medications fail, second-line treatments like deep brain stimulation or continuous infusions are crucial. A multidisciplinary approach ensures personalized care, improving patient quality of life.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Parkinson's disease (PD) initially responds to dopaminergic therapy.
- Disease progression leads to motor complications like fluctuations and dyskinesias.
- Optimization of oral therapy may become insufficient.
Purpose of the Study:
- To review second-line treatment strategies for advanced Parkinson's disease.
- To outline criteria for patient selection and therapeutic choices.
- To emphasize the role of multidisciplinary care and general practitioners.
Main Methods:
- Review of established second-line treatments for Parkinson's disease.
- Discussion of multidisciplinary assessment criteria.
- Identification of simple tools for patient eligibility screening.
Main Results:
- Second-line options include deep brain stimulation, continuous subcutaneous infusions (apomorphine, foslevodopa-foscarbidopa), and intra-intestinal levodopa infusions.
- Patient selection requires assessment of dopa-responsiveness, motor/cognitive status, comorbidities, and lifestyle.
- A simple screening tool involves daily L-dopa doses, OFF time, and dyskinesia duration.
Conclusions:
- Individualized treatment selection balances efficacy, tolerability, and practicalities.
- General practitioners are vital for complication identification, monitoring, and care coordination.
- Early, collaborative management significantly enhances the quality of life for Parkinson's patients.
Keywords:
Parkinson disease
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