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Device-aided therapies for advanced Parkinson disease: insights from an international survey

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Abstract

Purpose

In the advanced stage of Parkinson disease (PD), therapeutic interventions include device-aided therapies such as continuous subcutaneous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel (LCIG) infusion, and deep brain stimulation (DBS). Recent evidence has underlined the general lack of randomized, blinded, head-to-head studies on device-aided therapies for advanced PD.

Methods

To better clarify the real-world attitude of clinicians on this matter, we conducted an international survey of forty-four experienced movement disorder specialists regarding the management of device-aided therapies in advanced PD.

Results

Our international survey showed a general agreement that nowadays, motor complications are less common compared to the past (59% agreement), that guidelines to identify candidates for device-aided therapies are currently lacking (57% agreement), and that device-aided therapies will have increased demand in the future (75% agreement).

Conclusions

We conclude that guidelines to assist clinicians and patients to choose device-aided therapies are required.

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Acknowledgements

We wish to thank all the movement disorder experts that have participated to the international survey.

Author information

Authors and Affiliations

  1. Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, 260 Stetson Street, Cincinnati, OH, 45219, USA

    Luca Marsili

  2. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Matteo Bologna

  3. IRCCS Neuromed, Pozzilli, IS, Italy

    Matteo Bologna

  4. Department of Medicine, Division of Neurology, Parkinson and Movement Disorders Program and the Complex Neurologic Symptoms Clinic, Kaye Edmonton Clinic, University of Alberta, Edmonton, AL, Canada

    Janis M. Miyasaki

  5. Department of Neurology, Santa Maria University Hospital, Terni, Italy

    Carlo Colosimo

Authors
  1. Luca Marsili
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  2. Matteo Bologna
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  3. Janis M. Miyasaki
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  4. Carlo Colosimo
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Contributions

Conception and design: LM, CC

Acquisition of data: LM, MB,

Drafting the article: LM, MB

Revising the article for important intellectual content: LM, MB, JMM, CC

Approval of article and agreement for submission: LM, MB, JMM, CC

All the co-authors listed above gave their final approval of this manuscript version.

Corresponding author

Correspondence to Luca Marsili.

Ethics declarations

The submitting author has circulated the article and secured the final approval of the version to be peer-reviewed from all co-authors prior to the publication of the article.

Conflict of interest

The authors disclose no conflicts of interest regarding this manuscript. Luca Marsili and Matteo Bologna report no conflict of interest. Janis Miyasaki reports research grants from Patient Centered Outcomes Research Institute, University Hospital Foundation, Edmonton, Canada, and Parkinson Foundation, USA. Carlo Colosimo received grants from Abbvie, Alfasigma, BIAL, Ipsen, and Zambon unrelated to the present research, honoraria from the Movement Disorders Society, and publishing royalties Oxford University press and Cambridge University Press.

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Marsili, L., Bologna, M., Miyasaki, J.M. et al. Device-aided therapies for advanced Parkinson disease: insights from an international survey. Neurol Sci 42, 2961–2964 (2021). https://doi.org/10.1007/s10072-021-05106-4

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  • DOI: https://doi.org/10.1007/s10072-021-05106-4

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