What was first and what is next in selecting device-aided therapy in Parkinson’s disease? Balancing evidence and experience

Journal of Neural Transmission, Journal Year: 2024, Volume and Issue: 131(11), P. 1307 - 1320

Published: May 15, 2024

Language: Английский

---

Effectiveness and safety of levodopa–entacapone–carbidopa infusion in Parkinson disease: A real‐world data study

European Journal of Neurology, Journal Year: 2024, Volume and Issue: 32(1)

Published: Oct. 28, 2024

Levodopa-entacapone-carbidopa intestinal gel (LECIG) infusion is a recently developed device-aided therapy for advanced Parkinson disease (PD) patients. The aim of this study was to report real-world evidence about the effectiveness, tolerability, and safety LECIG in PD

Language: Английский

---

Association of Patient Characteristics, Social Drivers of Health, and Geographic Location on Access to Device-Aided Therapies among Medicare Beneficiaries with Advanced Parkinson’s Disease

Parkinsonism & Related Disorders, Journal Year: 2025, Volume and Issue: 133, P. 107322 - 107322

Published: Feb. 6, 2025

Language: Английский

---

Device-aided therapies (DATs) in Parkinson’s disease (PD). The DATs-PD GETM Spanish Registry Protocol Study

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0316052 - e0316052

Published: March 31, 2025

Background and objective Device-aided therapies (DATs) are treatments indicated for people with Parkinson´s disease (PwP) experiencing clinical fluctuations that remain suboptimal despite conventional medication. New DATs have recently emerged such as levodopa-entacapone-carbidopa intestinal gel infusion (LECIG) subcutaneous of foslevodopa/foscarbidopa (fLD/fCD). Understanding the differences between various is essential. Patients Methods We present here protocol study DATs-PD GETM Spanish Registry. This a descriptive, observational, prospective, multicenter, open proposed registry progressive inclusion PwP treated DAT in daily practice conditions more 40 centers from Spain 10 years. The principal aim to know type our country (Spain) receive. Specific objectives compare characteristics patients, effectiveness, safety tolerability, identify predictors good response analyze by groups (gender, duration, phenotype, etc.). There baseline visit (V1; indication therapy), start (V2; initiation therapy) follow-up visits at 6 months ± 3 (V3_6M) after this annually years (V3_12M, V3_24M, Results on going. first patient was included April 10, 2024. Patient recruitment will be conducted until 31/DEC/2033. It estimated include minimum 3,000 patients. Conclusion help improve care PD patients DAT.

Language: Английский

---

Apomorphine: past, present and future in Parkinson’s disease and beyond

Parkinsonism & Related Disorders, Journal Year: 2025, Volume and Issue: unknown, P. 107872 - 107872

Published: May 1, 2025

Language: Английский

---

Advances in Deep Brain Stimulation: From Mechanisms to Applications

Journal of Neuroscience, Journal Year: 2023, Volume and Issue: 43(45), P. 7575 - 7586

Published: Nov. 8, 2023

Deep brain stimulation (DBS) is an effective therapy for various neurologic and neuropsychiatric disorders, involving chronic implantation of electrodes into target regions electrical delivery. Despite its safety efficacy, DBS remains underutilized therapy. Advances in the field DBS, including technology, mechanistic understanding, applications have potential to expand access use while also improving clinical outcomes. Developments such as MRI compatibility bidirectional systems capable sensing neural activity providing therapeutic stimulation, enabled advances our understanding mechanisms application. In this review, we summarize recent work exploring modulation networks. We cover current focusing on improved programming development novel paradigms that go beyond standards many which are by sensing-enabled DBS.

Language: Английский

---

Winding Back the Clock on Advanced Therapies: It’s Time to Get Smart

Journal of Parkinson s Disease, Journal Year: 2024, Volume and Issue: 14(7), P. 1527 - 1530

Published: Sept. 10, 2024

Our language affects patients' perceptions of therapies. In Parkinson's disease, emergent response fluctuations and dyskinesias typically trigger conversations around commencing an "Advanced Therapy" which carries notions Advanced Disease. The patient, resolute in their commitment to fighting the is misled. Chasing reassurance that disease has not yet progressed considerably; they may therefore resist a potentially life-changing therapy. Instead, we should offer "Smart Therapy". This term more accurately positively describes therapies on stabilize improve quality life, without focus negative connotations progression advanced disease.

Language: Английский

---

Indicações de cirurgia na Doença de Parkinson: análise abrangente de literatura

STUDIES IN HEALTH SCIENCES, Journal Year: 2024, Volume and Issue: 5(1), P. 109 - 120

Published: Jan. 26, 2024

A Doença de Parkinson (DP) é uma doença neurológica que afeta os movimentos, causando tremores, lentidão, rigidez muscular, desequilíbrio, além alterações na fala e escrita. Essa ocorre por degeneração das células situadas numa região do cérebro chamada substância nigra. Inicialmente, deve-se começar com o tratamento medicamentoso, quais são pautados concentração presente dopamina Todavia, tratamentos cirúrgicos transformaram manejo da Parkinson. As opções terapêuticas disponíveis para complicações motoras DP incluem estimulação cerebral profunda (ECP), procedimentos ablativos ou lesionais dispositivos infusão medicamentos dopaminérgicos. Dessa forma, crescente corpo literatura sobre indicações cirurgia DP, foi possível a realização revisão integrativa meio plataforma pubmed, seleção análise criteriosa dos artigos, fim revisar analisar as evidências atuais pacientes Nesta identificado orais, dopaminérgicas não dopaminérgicas, base desta doença, sendo eficaz no início tratamento. No entanto, progressão uso crônico terapias podem desenvolver flutuações discinesia. Portanto, cirúrgicas outras avançado devem ser consideradas cujos sintomas adequadamente controlados apenas orais. Os avançados considerados quando incômodas se tornam refratárias mudanças nos DRT padrão leva incômodos, exemplo, discinesia, mas também distúrbios controle impulsos.

---

Integrating technology into a successful apomorphine delivery program in Thailand: a 10-year journey of achievements with a five-motto concept

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: April 5, 2024

Introduction Apomorphine, a potent dopamine agonist, is therapeutic option for patients with Parkinson’s disease and motor fluctuations. However, the adoption of adherence to this therapy have been limited by need complex delivery devices specialized care as well resource consumption, posing challenges new physicians. Thailand unique example developing nation that has successfully implemented continued use employing cooperative technology dramatically enhanced apomorphine services. Methods Establishing services requires significant resources step-by-step solutions. We began our implementing various strategies in three chronological stages: initial stage (2013–2015), intermediate (2016–2019), current (2020–present), each presenting challenges. Together, we also proposed set five mottos strengthen service. Using additive technology, developed patient registry platform combined electronic data acquisition, video remote monitoring using wearable sensors, in-house mobile applications support Results At stage, assembled team enhance efficacy confirm safety treatment hospital. expanded beyond just at supported other hospitals setting up their own educating both physicians nurses regarding therapy. With educational undertaking, increased apomorphine-related knowledge among medical professionals, greater number providing services, an increasing were administered subsequent years. Currently, are effective improve outcomes seamlessly integrating into clinical practice. Incorporating integrative technologies program yielded positive results collection throughout care, tracking patients’ statuses, long-term treatment, medication rates. Conclusion This perspective paper describes how can help provide supportive healthcare resource-constrained environments, such Thailand, offering approach overcoming several limitations. The valuable insights from 10-year journey benefit seeking replicate success.

Language: Английский

---

Grasping the big picture: impact analysis of screening tools for timely referral for device-aided therapies

Journal of Neural Transmission, Journal Year: 2024, Volume and Issue: 131(11), P. 1295 - 1305

Published: July 15, 2024

Several screening tools are available to assist general neurologists in the timely identification of patients with advanced Parkinson's disease (PD) who may be eligible for referral a device-aided therapy (DAT). However, it should noted that not all these clinical decision rules have been developed and validated thorough consistent manner. Furthermore, only limited number head-to-head comparisons performed. Available studies suggest D-DATS has higher positive predictive value specificity than 5-2-1 criteria, while sensitivity both is similar. unanswered questions remain regarding validity rules, such as whether diagnostic performance measures from validation generalizable other populations. Ultimately, question tool will effectively efficiently improve quality life PD. To address this key question, an impact analysis The authors intend set up multinational cluster randomised controlled trial compare criteria on downstream consequences implementing tools, particular focus disability life.

Language: Английский

---