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

  • Neurology and Preclinical Neurological Studies - Review Article
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Abstract

Parkinson’s disease (PD) progresses with motor fluctuations emerging several years after treatment initiation. Initially managed with oral medications, these fluctuations may later necessitate device-aided therapy (DATs). Globally, various DATs options are available, including continuous subcutaneous apomorphine infusion, deep brain stimulation, levodopa-carbidopa intestinal gel, levodopa-entacapone-carbidopa intestinal gel, and subcutaneous foslevodopa/foscarbidopa infusion, each with its complexities. Hence, matching complex patients with suitable therapy is critical. This review offers practical insights for physicians managing complex PD cases. Balancing evidence and experience is vital to select the most suitable DATs, considering factors like disease stage and patient preferences. Comparative analysis of DATs benefits and risks provides essential insights for clinicians and patients. Treatment sequences vary based on availability, patient needs, and disease progression. Less invasive options like apomorphine are often preferred initially, followed by other DATs if needed. Patient selection requires comprehensive evaluations, including motor function and cognitive status. Follow-up care involves symptom monitoring and adjusting medications. Customized treatment plans are essential for optimizing PD management with DATs.

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References

  • Aldred J, Freire-Alvarez E, Amelin AV, Antonini A, Bergmans B, Bergquist F et al (2023) Continuous Subcutaneous Foslevodopa/Foscarbidopa in Parkinson’s disease: safety and efficacy results from a 12-Month, Single-Arm, Open-Label, Phase 3 Study. Neurol Ther 12(6):1937–1958

    Article  PubMed  PubMed Central  Google Scholar 

  • Alfonso D, Cabrera LY, Sidiropoulos C, Wang F, Sarva H (2022) How Parkinson’s patients in the USA perceive deep brain stimulation in the 21st century: Results of a nationwide survey. J Clin Neurosci 95:20–26

    Article  CAS  PubMed  Google Scholar 

  • Ansari J (2010) Drug interaction and pharmacist. J Young Pharm 2(3):326–331

    Article  PubMed  PubMed Central  Google Scholar 

  • Antonini A (2009) Apomorphine and levodopa infusion therapies for advanced Parkinson’s disease. J Mov Disord 2(1):4–9

    Article  PubMed  PubMed Central  Google Scholar 

  • Antonini A, Odin P (2009) Pros and cons of apomorphine and L-dopa continuous infusion in advanced Parkinson’s disease. Parkinsonism Relat Disord 15(Suppl 4):S97-100

    Article  PubMed  Google Scholar 

  • Antonini A, Tolosa E (2009) Apomorphine and levodopa infusion therapies for advanced Parkinson’s disease: selection criteria and patient management. Expert Rev Neurother 9(6):859–867

    Article  CAS  PubMed  Google Scholar 

  • Antonini A, Odin P, Schmidt P, Cubillos F, Standaert DG, Henriksen T et al (2021) Validation and clinical value of the MANAGE-PD tool: A clinician-reported tool to identify Parkinson’s disease patients inadequately controlled on oral medications. Parkinsonism Relat Disord 92:59–66

    Article  CAS  PubMed  Google Scholar 

  • Aradi SD, Hauser RA (2020) Medical Management and Prevention of Motor Complications in Parkinson’s Disease. Neurotherapeutics 17(4):1339–1365

    Article  PubMed  PubMed Central  Google Scholar 

  • Armstrong MJ, Okun MS (2020) Diagnosis and treatment of Parkinson disease: a review. JAMA 323(6):548–560

    Article  PubMed  Google Scholar 

  • Auffret M, Weiss D, Stocchi F, Vérin M, Jost WH (2023) Access to device-aided therapies in advanced Parkinson’s disease: navigating clinician biases, patient preference, and prognostic uncertainty. J Neural Transm (vienna) 130(11):1411–1432

    Article  PubMed  Google Scholar 

  • Badihian N, Jackson LM, Klassen BT, Hassan A, Low PA, Singer W et al (2022) The effects of deep brain stimulation in patients with multiple system atrophy. J Parkinsons Dis 12(8):2595–2600

    Article  PubMed  PubMed Central  Google Scholar 

  • Basiago A, Binder DK (2016) Effects of deep brain stimulation on autonomic function. Brain Sci 6(3):33

    Article  PubMed  PubMed Central  Google Scholar 

  • Bhidayasiri R, Jitkritsadakul O, Boonrod N, Rerknimitr R (2014) Compassionate trial of levodopa carbidopa intestinal gel infusion in two patients with progressive supranuclear palsy. Clin Neurol Neurosurg 116:1–3

    Article  PubMed  Google Scholar 

  • Bhidayasiri R, Ray Chaudhuri K, LeWitt P, Martin A, Boonpang K, van Laar T (2015) Effective delivery of apomorphine in the management of Parkinson disease. Clin Neuropharmacol 38:89–103

    Article  CAS  PubMed  Google Scholar 

  • Bhidayasiri R, Boonpang K, Jitkritsadakul O, Calne SM, Henriksen T, Trump S et al (2016a) Understanding the role of the Parkinson’s disease nurse specialist in the delivery of apomorphine therpy. Parkinsonism Relat Disord 33(Suppl 1):S49-s55

    Article  PubMed  Google Scholar 

  • Bhidayasiri R, Sringean J, Anan C, Boonpang K, Thanawattano C, Ray CK (2016b) Quantitative demonstration of the efficacy of night-time apomorphine infusion to treat nocturnal hypokinesia in Parkinson’s disease using wearable sensors. Parkinsonism Relat Disord 33(Suppl 1):S36–S41

    Article  PubMed  Google Scholar 

  • Bhidayasiri R, Phokaewvarangkul O, Sakdisornchai K, Boonpang K, Chaudhuri KR, Parsons J et al (2020) Establishing apomorphine treatment in Thailand: understanding the challenges and opportunities of Parkinson’s disease management in developing countries. Expert Rev Neurother 20(6):523–537

    Article  CAS  PubMed  Google Scholar 

  • Braak H, Del Tredici K, Rub U, de Vos RA, Jansen Steur EN, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211

    Article  PubMed  Google Scholar 

  • Burack M, Aldred J, Zadikoff C, Vanagunas A, Klos K, Bilir B et al (2018) Implementing Levodopa-Carbidopa Intestinal Gel for Parkinson Disease: Insights from US Practitioners. Mov Disord Clin Pract 5(4):383–393

    Article  PubMed  PubMed Central  Google Scholar 

  • Cabrera LY, Young Han C, Ostendorf T, Jimenez-Shahed J, Sarva H (2021) Neurologists’ attitudes toward use and timing of deep brain stimulation. Neurol Clin Pract 11(6):506–516

    Article  PubMed  PubMed Central  Google Scholar 

  • Calabresi P, Di Filippo M, Ghiglieri V, Tambasco N, Picconi B (2010) Levodopa-induced dyskinesias in patients with Parkinson’s disease: filling the bench-to-bedside gap. Lancet Neurol 9(11):1106–1117

    Article  CAS  PubMed  Google Scholar 

  • Cochen De Cock V, Dodet P, Leu-Semenescu S, Aerts C, Abril B, Castelnovo G et al (2023) Night-Time Apomorphine Infusion: Who Are the Best Candidates? Mov Disord Clin Pract. 10(8):1192–1197

    Article  PubMed  PubMed Central  Google Scholar 

  • Collomb-Clerc A, Welter ML (2015) Effects of deep brain stimulation on balance and gait in patients with Parkinson’s disease: a systematic neurophysiological review. Neurophysiol Clin 45(4–5):371–388

    Article  CAS  PubMed  Google Scholar 

  • Constantin VA, Szasz JA, Orban-Kis K, Rosca EC, Popovici M, Cornea A et al (2020) Levodopa-Carbidopa intestinal gel infusion therapy discontinuation: a ten-year retrospective analysis of 204 treated patients. Neuropsychiatr Dis Treat 16:1835–1844

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Deng H, Wang P, Jankovic J (2018) The genetics of Parkinson disease. Ageing Res Rev 42:72–85

    Article  CAS  PubMed  Google Scholar 

  • Dietrichs E, Odin P (2017) Algorithms for the treatment of motor problems in Parkinson’s disease. Acta Neurol Scand 136(5):378–385

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Drapier S, Gillioz AS, Leray E, Peron J, Rouaud T, Marchand A et al (2012) Apomorphine infusion in advanced Parkinson’s patients with subthalamic stimulation contraindications. Parkinsonism Relat Disord 18(1):40–44

    Article  PubMed  Google Scholar 

  • Du J, Liu X, Zhou X, Wang H, Zhou W, Jiang J et al (2020) Parkinson’s disease-related risk of suicide and effect of deep brain stimulation: meta-analysis. Parkinsons Dis 2020:8091963

    PubMed  PubMed Central  Google Scholar 

  • Fox SH, Katzenschlager R, Lim SY, Barton B, de Bie RMA, Seppi K et al (2018) International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson’s disease. Mov Disord 33(8):1248–1266

    Article  CAS  PubMed  Google Scholar 

  • Freitas ME, Hess CW, Fox SH (2017) Motor complications of dopaminergic medications in Parkinson’s disease. Semin Neurol 37(2):147–157

    Article  PubMed  PubMed Central  Google Scholar 

  • Fung VSC, Aldred J, Arroyo MP, Bergquist F, Boon AJW, Bouchard M et al (2024) Continuous subcutaneous foslevodopa/foscarbidopa infusion for the treatment of motor fluctuations in Parkinson’s disease: sonsiderations for initiation and maintenance. Clin Park Relat Disord 10:100239

    PubMed  PubMed Central  Google Scholar 

  • Georgiev D, Delalic S, Zupancic Kriznar N, Socher A, Gurevich T, Trost M (2022) Switching and combining device-aided therapies in advanced parkinson’s disease: a double centre retrospective study. Brain Sci 12(3):343

    Article  PubMed  PubMed Central  Google Scholar 

  • Hariz M, Blomstedt P (2022) Deep brain stimulation for Parkinson’s disease. J Intern Med 292(5):764–778

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Henriksen T, Staines H (2021) Continuous Subcutaneous Apomorphine Infusion in Parkinson’s Disease: A Single-Center, Long-Term Follow-Up Study of the Causes for Discontinuation. J Pers Med. 11(6):525

    Article  PubMed  PubMed Central  Google Scholar 

  • Henriksen T, Dalhoff KP, Hansen HE, Brenneche AW, Lonberg US, Danielsen EH (2020) Access and use of device-aided therapies for parkinson’s disease in denmark. Mov Disord Clin Pract 7(6):656–663

    Article  PubMed  PubMed Central  Google Scholar 

  • Hughes AJ, Colosimo C, Kleedorfer B, Daniel SE, Lees AJ (1992) The dopaminergic response in multiple system atrophy. J Neurol Neurosurg Psychiatry 55(11):1009–1013

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • National Institute for Health and Care Excellence. Parkinson’s disease in adults, 19 July 2017. www.nice.org.uk/guidance/ng71.

  • Jing XZ, Yuan XZ, Luo X, Zhang SY, Wang XP (2023) An update on nondopaminergic treatments for motor and non-motor symptoms of Parkinson’s disease. Curr Neuropharmacol 21(8):1806–1826

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kasper S, Muller-Spahn F (2002) Intravenous antidepressant treatment: focus on citalopram. Eur Arch Psychiatry Clin Neurosci 252(3):105–109

    Article  CAS  PubMed  Google Scholar 

  • Katz M, Kilbane C, Rosengard J, Alterman RL, Tagliati M (2011) Referring patients for deep brain stimulation: an improving practice. Arch Neurol 68(8):1027–1032

    Article  PubMed  Google Scholar 

  • Kobylecki C, Partington-Smith L (2023) Home initiation of apomorphine infusion: lessons from the COVID-19 pandemic and implications for current clinical practice. J Neural Transm (vienna) 130(11):1485–1489

    Article  PubMed  Google Scholar 

  • Leta V, Klingelhoefer L, Longardner K, Campagnolo M, Levent HC, Aureli F et al (2023) Gastrointestinal barriers to levodopa transport and absorption in Parkinson’s disease. Eur J Neurol 30(5):1465–1480

    Article  PubMed  Google Scholar 

  • Lokk J (2011) Lack of information and access to advanced treatment for Parkinson’s disease patients. J Multidiscip Healthc 4:433–439

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Malaty IA, Martinez-Martin P, Chaudhuri KR, Odin P, Skorvanek M, Jimenez-Shahed J et al (2022) Does the 5-2-1 criteria identify patients with advanced Parkinson’s disease? Real-world screening accuracy and burden of 5-2-1-positive patients in 7 countries. BMC Neurol 22(1):35

    Article  PubMed  PubMed Central  Google Scholar 

  • Martinez-Martin P, Kulisevsky J, Mir P, Tolosa E, Garcia-Delgado P, Luquin MR (2018) Validation of a simple screening tool for early diagnosis of advanced Parkinson’s disease in daily practice: the CDEPA questionnaire. NPJ Parkinsons Dis 4:20

    Article  PubMed  PubMed Central  Google Scholar 

  • Meira B, Degos B, Corsetti E, Doulazmi M, Berthelot E, Virbel-Fleischman C et al (2021) Long-term effect of apomorphine infusion in advanced Parkinson’s disease: a real-life study. NPJ Parkinsons Dis 7(1):50

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Metta V, Batzu L, Leta V, Trivedi D, Powdleska A, Mridula KR et al (2021) Parkinson’s Disease: Personalized Pathway of Care for Device-Aided Therapies (DAT) and the Role of Continuous Objective Monitoring (COM) Using Wearable Sensors. J Pers Med. 11(7):680

    Article  PubMed  PubMed Central  Google Scholar 

  • Moes HR, Groenendal-Laurensse J, Drent M, Tissingh G, van Laar T (2020) Predictors of Time to Discontinuation of Levodopa-Carbidopa Intestinal Gel Infusion: A Retrospective Cohort Study. J Parkinsons Dis 10(3):935–944

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Moes HR, Henriksen T, Slawek J, Phokaewvarangkul O, Buskens E, van Laar T (2023) Tools and criteria to select patients with advanced Parkinson’s disease for device-aided therapies: a narrative review. J Neural Transm (vienna) 130(11):1359–1377

    Article  PubMed  Google Scholar 

  • Nijhuis FAP, van den Heuvel L, Bloem BR, Post B, Meinders MJ (2019) The Patient’s Perspective on Shared Decision-Making in Advanced Parkinson’s Disease: A Cross-Sectional Survey Study. Front Neurol 10:896

    Article  PubMed  PubMed Central  Google Scholar 

  • Nijkrake MJ, Keus SH, Kalf JG, Sturkenboom IH, Munneke M, Kappelle AC et al (2007) Allied health care interventions and complementary therapies in Parkinson’s disease. Parkinsonism Relat Disord 13(Suppl 3):S488–S494

    Article  PubMed  Google Scholar 

  • Nutt JG, Woodward WR, Anderson JL (1985) The effect of carbidopa on the pharmacokinetics of intravenously administered levodopa: the mechanism of action in the treatment of parkinsonism. Ann Neurol 18(5):537–543

    Article  CAS  PubMed  Google Scholar 

  • Nyholm D, Jost WH (2022) Levodopa-entacapone-carbidopa intestinal gel infusion in advanced Parkinson’s disease: real-world experience and practical guidance. Ther Adv Neurol Disord 15:17562864221108018

    Article  PubMed  PubMed Central  Google Scholar 

  • Odin P, Ray Chaudhuri K, Slevin JT, Volkmann J, Dietrichs E, Martinez-Martin P et al (2015) Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson’s disease: Consensus from an international survey and discussion program. Parkinsonism Relat Disord 21(10):1133–1144

    Article  CAS  PubMed  Google Scholar 

  • Olivola E, Fasano A, Varanese S, Lena F, Santilli M, Femiano C et al (2019) Continuous subcutaneous apomorphine infusion in Parkinson’s disease: causes of discontinuation and subsequent treatment strategies. Neurol Sci 40(9):1917–1923

    Article  PubMed  Google Scholar 

  • Pan S, Stutzbach J, Reichwein S, Lee BK, Dahodwala N (2014) Knowledge and attitudes about Parkinson’s disease among a diverse group of older adults. J Cross Cult Gerontol 29(3):339–352

    Article  PubMed  PubMed Central  Google Scholar 

  • Pfeiffer RF, Isaacson SH, Pahwa R (2020) Clinical implications of gastric complications on levodopa treatment in Parkinson’s disease. Parkinsonism Relat Disord 76:63–71

    Article  PubMed  Google Scholar 

  • Phokaewvarangkul O, Anan C, Phimpha A, Chaudhuri KR, van Laar T, Bhidayasiri R (2021) Early factors for predicting discontinuation to subcutaneous Apomorphine infusion in Parkinson’s disease: A prospective analysis of the Thai Apomorphine Registry. Parkinsonism Relat Disord 91:146–151

    Article  CAS  PubMed  Google Scholar 

  • Pietz K, Hagell P, Odin P (1998) Subcutaneous apomorphine in late stage Parkinson’s disease: a long term follow up. J Neurol Neurosurg Psychiatry 65(5):709–716

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pirtosek Z, Bajenaru O, Kovacs N, Milanov I, Relja M, Skorvanek M (2020) Update on the management of Parkinson’s disease for general neurologists. Parkinsons Dis 2020:9131474

    PubMed  PubMed Central  Google Scholar 

  • Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30(12):1591–1601

    Article  PubMed  Google Scholar 

  • Reddy P, Martinez-Martin P, Brown RG, Chaudhuri KR, Lin JP, Selway R et al (2014) Perceptions of symptoms and expectations of advanced therapy for Parkinson’s disease: preliminary report of a Patient-Reported Outcome tool for Advanced Parkinson’s disease (PRO-APD). Health Qual Life Outcomes 12:11

    Article  PubMed  PubMed Central  Google Scholar 

  • J Reiling RG Hughes MR Murphy The Impact of Facility Design on Patient Safety In: RG Hughes ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses Advances in Patient Safety Rockville MD

  • Rissardo JP, Vora NM, Tariq I, Mujtaba A, Caprara ALF (2023) Deep brain stimulation for the management of refractory neurological disorders: a comprehensive review. Medicina (kaunas) 59(11):1991

    Article  PubMed  Google Scholar 

  • Rolston JD, Englot DJ, Starr PA, Larson PS (2016) An unexpectedly high rate of revisions and removals in deep brain stimulation surgery: Analysis of multiple databases. Parkinsonism Relat Disord 33:72–77

    Article  PubMed  PubMed Central  Google Scholar 

  • Santos-Garcia D, Macias M, Llaneza M, Aneiros A (2009) Suicide following duodenal levodopa infusion for Parkinson’s disease. Mov Disord 24(13):2029–2030

    Article  PubMed  Google Scholar 

  • Soileau MJ, Aldred J, Budur K, Fisseha N, Fung VS, Jeong A et al (2022) Safety and efficacy of continuous subcutaneous foslevodopa-foscarbidopa in patients with advanced Parkinson’s disease: a randomised, double-blind, active-controlled, phase 3 trial. Lancet Neurol 21(12):1099–1109

    Article  CAS  PubMed  Google Scholar 

  • Tenison E, James A, Ebenezer L, Henderson EJ (2022) A Narrative review of specialist Parkinson’s nurses: evolution, evidence and expectation. Geriatrics (basel) 7(2):46

    Article  PubMed  Google Scholar 

  • Thaler A, Barer Y, Gross R, Cohen R, Bergmann L, Jalundhwala YJ et al (2022) Long-term persistence and monotherapy with device-aided therapies: a retrospective analysis of an israeli cohort of patients with advanced Parkinson’s disease. Adv Ther 39(5):2009–2024

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Trenkwalder C, Chaudhuri KR, Garcia Ruiz PJ, LeWitt P, Katzenschlager R, Sixel-Doring F et al (2015) Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson’s disease–Clinical practice recommendations. Parkinsonism Relat Disord 21(9):1023–1030

    Article  PubMed  Google Scholar 

  • van Halteren AD, Munneke M, Smit E, Thomas S, Bloem BR, Darweesh SKL (2020) Personalized care management for persons with Parkinson’s disease. J Parkinsons Dis 10(s1):S11–S20

    Article  PubMed  PubMed Central  Google Scholar 

  • Wan Yunus F, Ahmad Ridhuwan NF, Romli MH (2022) The perception of allied health professionals on occupational therapy. Occup Ther Int 2022:2588902

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhang C, Ramirez-Zamora A, Meng F, Lin Z, Lai Y, Li D et al (2020) An International survey of deep brain stimulation utilization in Asia and Oceania: the DBS think tank east. Front Hum Neurosci 14:162

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors extend their gratitude to thank Wolfgang H. Jost, Christian Riederer and Britannia Pharmaceuticals Limited for organising the 2023 PD expert meeting in Frankfurt, Germany, which paved the way for this paper.

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Authors and Affiliations

  1. Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Onanong Phokaewvarangkul & Roongroj Bhidayasiri

  2. France Développement Electronique (FDE), Monswiller, France, Institut Des Neurosciences Cliniques de Rennes (INCR), Rennes, France, Behavior and Basal Ganglia Research Unit, CIC-IT, CIC1414, Pontchaillou University Hospital and University of Rennes, Rennes, France

    Manon Auffret

  3. Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany

    Sergiu Groppa

  4. Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia

    Vladana Markovic & Igor Petrovic

  5. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Vladana Markovic & Igor Petrovic

  6. The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand

    Roongroj Bhidayasiri

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  1. Onanong Phokaewvarangkul
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All authors (OP, MA, SG, VM, IP, and RB) contributed to the study conception and design. The first draft of the manuscript was written by OP and revised by RB, and all authors commented on previous versions of the manuscript. The final draft of the manuscript was revised by OP and RB, and all authors read and approved the final manuscript.

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Correspondence to Roongroj Bhidayasiri.

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Phokaewvarangkul, O., Auffret, M., Groppa, S. et al. What was first and what is next in selecting device-aided therapy in Parkinson’s disease? Balancing evidence and experience. J Neural Transm (2024). https://doi.org/10.1007/s00702-024-02782-2

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