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02 November 2017
Article (Scientific journals)
Classification of advanced stages of Parkinson's disease: translation into stratified treatments.
Krüger, Rejko; Klucken, Jochen; Weiss, Daniel et al.
2017In Journal of Neural Transmission, 124 (124), p. 1015-1027
Peer Reviewed verified by ORBi


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Keywords :
Advanced Parkinson's disease; Invasive therapies; Personalized medicine; Stratification
Abstract :
[en] Advanced stages of Parkinson's disease (advPD) still impose a challenge in terms of classification and related stage-adapted treatment recommendations. Previous concepts that define advPD by certain milestones of motor disability apparently fall short in addressing the increasingly recognized complexity of motor and non-motor symptoms and do not allow to account for the clinical heterogeneity that require more personalized approaches. Therefore, deep phenotyping approaches are required to characterize the broad-scaled, continuous and multidimensional spectrum of disease-related motor and non-motor symptoms and their progression under real-life conditions. This will also facilitate the reasoning for clinical care and therapeutic decisions, as neurologists currently have to refer to clinical trials that provide guidance on a group level; however, this does not always account for the individual needs of patients. Here, we provide an overview on different classifications for advPD that translate into critical phenotypic patterns requiring the differential therapeutic adjustments. New concepts refer to precision medicine approaches also in PD and first studies on genetic stratification for therapeutic outcomes provide a potential for more objective treatment recommendations. We define novel treatment targets that align with this concept and make use of emerging device-based assessments of real-life information on PD symptoms. As these approaches require empowerment of patients and integration into treatment decisions, we present communication strategies and decision support based on new technologies to adjust treatment of advPD according to patient demands and safety.
Research center :
- Luxembourg Centre for Systems Biomedicine (LCSB): Clinical & Experimental Neuroscience (Krüger Group)
Disciplines :
Author, co-author :
Krüger, Rejko ;  University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > Life Science Research Unit
Klucken, Jochen
Weiss, Daniel
Tonges, Lars
Kolber, Pierre Luc ;  University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB)
Unterecker, Stefan
Lorrain, Michael
Baas, Horst
Muller, Thomas
Riederer, Peter
External co-authors :
Language :
Title :
Classification of advanced stages of Parkinson's disease: translation into stratified treatments.
Publication date :
24 March 2017
Journal title :
Journal of Neural Transmission
Publisher :
Springer, Germany
Volume :
Issue :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
FNR - Fonds National de la Recherche
CE - Commission Européenne


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