Advanced treatment options for Parkinson’s disease

This study aimed to investigate the advanced treatment options available to treat Parkinson's disease. This study found that advanced treatment options should be used to create an individual treatment option for each patient to help with motor and non-motor symptoms. 

Parkinson’s disease (PD) affects the nerve cells in the brain that produce dopamine. PD symptoms include muscle rigidity, tremors, and changes in speech and walk. Symptoms can be split into motor (such as tremor) and non-motor (such as depression). There are many treatment options for PD. Bilateral subthalamic stimulation (STN-DBS) is a surgical option where the brain is stimulated. Intrajejunal levodopa infusion (IJLI) is where medication is put into the abdomen directly.  Apomorphine (APO; Apokin) acts like dopamine to stimulate nerve cells. It is given through a continuous pump.

The effect of these options have on PD symptoms are unclear. 

This study included 173 patients. 101 patients had STN-DBS. 33 patients had IJLI. 39 patients had APO. These patients were followed up using questionnaires to evaluate symptoms and quality of life (QoL). This was done at the beginning of the study and six months after treatment started. 

QoL and symptoms improved for all groups. STN-DBS improved urinary/sexual symptoms, mood, and sleep. IJLI improved mood, and symptoms such as constipation. APO helped with mood, attention, memory. STN-DBS and IJLI seemed favorable for non-motor symptoms. APO was superior in terms of neurological symptoms. 

This study found that these advanced treatment options are beneficial for patients with PD. The authors suggest that these treatments should be used to create an individual treatment option for each patient to help with motor and non-motor symptoms. 

The number of patients in each group was unequal and quite small and the follow-up period was short. Further, larger trials are needed.