Article (Scientific journals)
Advanced stages of PD: interventional therapies and related patient-centered care
KRÜGER, Rejko; Hilker, Rudiger; Winkler, Christian et al.
2016In Journal of Neural Transmission
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Keywords :
Parkinson’s disease; Deep brain stimulation; Levodopa-carbidopa intestinal gel; Apomorphine; Patientcentred care; Motor complications
Abstract :
[en] During the last decades, symptomatic treatment of motor symptoms of Parkinson's disease (PD) improved continuously and is reflected by long-range independency of the patient during the disease course. However, advanced stages of PD still represent an important challenge to patients, caregivers and treating physicians. In patients with advanced PD, interventional therapy strategies are increasingly applied. These device-related treatment strategies using pump-based continuous dopaminergic stimulation (CDS) or deep brain stimulation (DBS) opened new treatment options especially if motor complications predominate. Well-designed clinical studies on these interventional therapeutic approaches provided class 1 evidence for the efficacy of DBS and CDS in advanced PD and opened new perspectives for their use in earlier disease stages also. Therefore, careful selection of patients amenable to the (semi)invasive therapy options becomes more and more important and requires an interdisciplinary setting that accounts for (i) optimal patient information and awareness, (ii) selection of best individual treatment modality, (iii) training of relatives and caregivers, (iv) management of complications, and (v) follow-up care. Here, we address these topics by summarizing current state-of-the-art in patient selection, providing specificities of treatment options and troubleshooting, and defining steps towards an optimized patient-centered care. Interventional therapies pioneer in the area of individualized treatment approaches for PD, and may be complemented in the future by biomarker-based improved stratification and by closed-loop systems for adaptive therapeutic strategies. In the present review, we summarize the proceedings of an Expert Workshop on Parkinson's disease held on November 22, 2014 in Frankfurt, Germany.
Research center :
- Luxembourg Centre for Systems Biomedicine (LCSB): Clinical & Experimental Neuroscience (Krüger Group)
Disciplines :
Neurology
Author, co-author :
KRÜGER, Rejko ;  University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > Life Science Research Unit
Hilker, Rudiger
Winkler, Christian
Lorrain, Michael
Hahne, Matthias
Redecker, Christoph
Lingor, Paul
Jost, Wolfgang H.
External co-authors :
yes
Language :
English
Title :
Advanced stages of PD: interventional therapies and related patient-centered care
Publication date :
2016
Journal title :
Journal of Neural Transmission
ISSN :
0300-9564
eISSN :
1435-1463
Publisher :
Springer
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBilu :
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