Device-aided therapies for advanced Parkinson disease: insights from an international survey

Neurol Sci. 2021 Jul;42(7):2961-2964. doi: 10.1007/s10072-021-05106-4. Epub 2021 Feb 6.

Abstract

Purpose: In the advanced stage of Parkinson disease (PD), therapeutic interventions include device-aided therapies such as continuous subcutaneous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel (LCIG) infusion, and deep brain stimulation (DBS). Recent evidence has underlined the general lack of randomized, blinded, head-to-head studies on device-aided therapies for advanced PD.

Methods: To better clarify the real-world attitude of clinicians on this matter, we conducted an international survey of forty-four experienced movement disorder specialists regarding the management of device-aided therapies in advanced PD.

Results: Our international survey showed a general agreement that nowadays, motor complications are less common compared to the past (59% agreement), that guidelines to identify candidates for device-aided therapies are currently lacking (57% agreement), and that device-aided therapies will have increased demand in the future (75% agreement).

Conclusions: We conclude that guidelines to assist clinicians and patients to choose device-aided therapies are required.

Keywords: Advanced stages; Device-aided therapies; Parkinson disease; Survey.

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Apomorphine / therapeutic use
  • Carbidopa / therapeutic use
  • Deep Brain Stimulation*
  • Drug Combinations
  • Gels / therapeutic use
  • Humans
  • Infusions, Parenteral
  • Levodopa / therapeutic use
  • Parkinson Disease* / drug therapy

Substances

  • Antiparkinson Agents
  • Drug Combinations
  • Gels
  • Levodopa
  • Carbidopa
  • Apomorphine