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

Journal of Neural Transmission, Год журнала: 2024, Номер 131(11), С. 1307 - 1320

Опубликована: Май 15, 2024

Язык: 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, Год журнала: 2025, Номер 133, С. 107322 - 107322

Опубликована: Фев. 6, 2025

Язык: Английский

---

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

European Journal of Neurology, Год журнала: 2024, Номер 32(1)

Опубликована: Окт. 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

Язык: Английский

---

Advances in Deep Brain Stimulation: From Mechanisms to Applications

Journal of Neuroscience, Год журнала: 2023, Номер 43(45), С. 7575 - 7586

Опубликована: Ноя. 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.

Язык: Английский

---

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

Journal of Parkinson s Disease, Год журнала: 2024, Номер 14(7), С. 1527 - 1530

Опубликована: Сен. 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.

Язык: Английский

---

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

PLoS ONE, Год журнала: 2025, Номер 20(3), С. e0316052 - e0316052

Опубликована: Март 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.

Язык: Английский

---

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

Parkinsonism & Related Disorders, Год журнала: 2025, Номер unknown, С. 107872 - 107872

Опубликована: Май 1, 2025

The year 2025 marks the 180th anniversary of first documented synthesis apomorphine, and U.S. Food Drug Administration (FDA) approval a subcutaneous apomorphine infusion device for advanced Parkinson's disease (SPN-830). This narrative review therefore aims to examine clinical journey, celebrating its turbulent yet founding past, analyzing current challenges in treatment (PD) envisioning promising future, both neurological disorders beyond. Enduring misconceptions lack class 1 evidence supporting use continuous (CSAI) PD have long been thought prevented generalized use. TOLEDO study, which robustly demonstrated clinically meaningful reduction off time (as expected based on decades experience) has now removed this barrier. Challenges be addressed moving forward include (1) redefining place paradigm (from early terminal care), (2) reducing access disparities (availability, cost), (3) improving delivery systems formulations, (4) expanding outside disorders, with already tangible results atypical Parkinsonian syndromes consciousness, perspectives Alzheimer's disease.

Язык: Английский

---

Patients’ experience with and perspectives on long-term use of continuous subcutaneous infusion of foslevodopa/foscarbidopa in Parkinson’s disease

Journal of Neurology, Год журнала: 2025, Номер 272(6)

Опубликована: Май 22, 2025

Язык: Английский

---

DEFINING ‘OFF’ TIME IN DEVICE-AIDED THERAPY CRITERIA FOR PARKINSON’S DISEASE: GAPS AND OPPORTUNITIES

Parkinsonism & Related Disorders, Год журнала: 2025, Номер unknown, С. 107894 - 107894

Опубликована: Май 1, 2025

Язык: Английский

---

No one size fits all approach with apomorphine initiation

Parkinsonism & Related Disorders, Год журнала: 2025, Номер unknown, С. 107889 - 107889

Опубликована: Май 1, 2025

Continuous subcutaneous apomorphine infusion (CSAI) is an important treatment for motor fluctuations in the complex phase of Parkinson's disease (PD). Several barriers to accessing CSAI exist, including perceptions how initiation should occur. The majority published work on reports inpatient admission this treatment, but restrictions access hospital beds may limit availability. We review here evidence different approaches, outpatient/daycase or home initiation. Whereas allows faster titration has been found allow effective and safe offers potential cost savings. Complication rates all approaches appear comparable, although overall clinical profile comorbitidities patients be taken into account when deciding best method A flexible approach benefits people with PD terms better access.

Язык: Английский

---