scholarly journals Management of Advanced Therapies in Parkinson's Disease Patients in Times of Humanitarian Crisis: The COVID ‐19 Experience

2020 ◽  
Vol 7 (4) ◽  
pp. 361-372 ◽  
Author(s):  
Alfonso Fasano ◽  
Angelo Antonini ◽  
Regina Katzenschlager ◽  
Paul Krack ◽  
Per Odin ◽  
...  

2021 ◽  
pp. 1-6
Author(s):  
Mark Tomishima ◽  
Agnete Kirkeby

After many years of preclinical development, cell and gene therapies have advanced from research tools in the lab to clinical-grade products for patients, and today they constitute more than a quarter of all new Phase I clinical trials for Parkinson’s disease. Whereas efficacy has been convincingly proven for many of these products in preclinical models, the field is now entering a new phase where the functionality and safety of these products will need to stand the test in clinical trials. If successful, these new products can have the potential to provide patients with a one-time administered treatment which may alleviate them from daily symptomatic dopaminergic medication.



2020 ◽  
pp. 1-9 ◽  
Author(s):  
Joke M. Dijk ◽  
Alberto J. Espay ◽  
Regina Katzenschlager ◽  
Rob M.A. de Bie


2012 ◽  
Vol 7 (2) ◽  
pp. 113
Author(s):  
Johan Lökk ◽  
Ulf Persson ◽  
Michael Wainwright ◽  
◽  
◽  
...  

From a broad societal perspective, the economic burden of Parkinson’s disease ranges from direct medication expenses to costs associated with home help and lost production. The last two generally arise in the more advanced stages of the disease. Savings are nevertheless possible and the two main ways of attaining this are by slowing down disease progression and reducing the time patients spend in off-periods. Earlier onset of optimised treatment, both in the initial and later disease stages, has the potential to achieve both. We highlight examples of advanced therapies that alleviate severe motor symptoms and thereby prolong the time patients can remain in their own homes and at their places of work. Health economic calculations for two forms of advanced therapy, continuous dopaminergic stimulation via pumps and deep brain stimulation, are also shown.



Author(s):  
Ingrid Metzler ◽  
Paul Just

Narratives of hope shape contemporary engagements with Parkinson’s disease. On the one hand, a “biomedical narrative of hope” promises that biomedical research will help to transform this treatable but incurable disease into a curable one in the future. On the other hand, a more individual “illness narrative of hope” encourages patients to influence the course of Parkinson’s disease by practicing self-care and positive thinking. This article asks how these two narratives of hope interact. It bases its argument on an analysis of data from 13 focus groups conducted in Germany in 2012 and 2014 with patients with Parkinson’s disease and their relatives. Participants were asked to have their say on clinical trials for advanced therapies for Parkinson’s disease and, while doing so, envisioned their biosocial selves in the present and the future. Three “modes of being” for patients were drawn from this body of data: a “users on stand-by” mode, an “unengaged” mode, and an “experimental pioneers” mode. Both narratives of hope were important to all three modes, yet they were mobilized at different frequencies and also had different statuses. While the biomedical narrative of hope was deemed an important “dream of the future” that participants passively supported without having to make it their own, the illness narrative of hope was a truth discourse that took an imperative form: having Parkinson’s disease implied the need to maintain a positive attitude.



Author(s):  
S Sasikumar ◽  
R Matta ◽  
A Fasano

Background: Dopamine Dysregulation Syndrome (DDS) is an adverse non-motor complication of dopamine replacement therapy in Parkinson’s Disease. The current literature on DDS is limited, and it remains underdiagnosed and challenging to manage. Methods: We performed a retrospective chart review and classified patients according to risk factors that have been identified in the literature, UPDRS scores, intervention and outcome. Univariate analyses were performed to quantify these characteristics. Results: Prior psychiatric illness was identified in 70% of patients, impulse control disorder in 89% and substance abuse in 3.7%. Interventions included reduction of dopamine therapy (88.9%), deep brain stimulation (DBS) of the subthalamic nucleus (STN, 48.1%) or globus pallidus interna (GPi, 7.4%), and levodopa-carbidopa intestinal gel (LCIG) infusion (11.1%). Baseline UPDRS IV before treatment and MDS III after treatment were not significant between intervention groups (p=0.09 and p=0.13 respectively). Overall 88.9% patients improved at follow up, with medication only (75%), STN DBS (100%), GPi DBS (100%) and LCIG (33%). Relapse rate was 18.2%, in the STN group only. Conclusions: Our results suggest that GPi DBS, in concurrence with dopaminergic medication reduction, is the most effective intervention. STN DBS might be also beneficial although the associated medications reduction causes DDS relapse in a subgroup of patients.



2021 ◽  
pp. 1-12
Author(s):  
Anna Sauerbier ◽  
Pia Bachon ◽  
Leire Ambrosio ◽  
Philipp A. Loehrer ◽  
Alexandra Rizos ◽  
...  

Background: The satisfaction with life and, in particular, with treatment in Parkinson’s disease (PD) is understudied. Objective: To explore a new 7-item rating tool assessing satisfaction with life and treatment (SLTS-7) in PD. Methods: In this cross-sectional, multi-center study, including patients screened for advanced therapies, psychometric characteristics of the SLTS-7 were analyzed. An exploratory factor analysis identified the underlying factorial structure of the SLTS-7. Results: 117 patients were included, and the data quality of the SLTS-7 was excellent (computable data 100%), and acceptability measures satisfied standard criteria. Besides the global assessment (item 1), the exploratory factor analysis produced item 2 (physical satisfaction) as an independent item and two factors among the remaining items: items 3–5 (psycho-social satisfaction), and items 6 and 7 (treatment satisfaction). Cronbach’s alpha was 0.89, indicative of high internal consistency. The SLTS-7 total score correlated moderately with motor symptoms and weakly with non-motor symptoms total scores. SLTS-7 showed the highest correlations with the European Quality of Life with 5 items (EQ-5D) visual analog scale (0.43–0.58, p <  0.01), indicating a moderate convergent validity. The SLTS-7 significantly increased with higher non-motor symptoms burden levels (p = 0.002). Conclusion: Life satisfaction in PD covers three specific aspects, namely physical, psycho-social, and treatment satisfaction. The new SLTS-7 is a valid, reliable, and easy-to-use tool to assess satisfaction with life and treatment in patients with PD screened for advanced therapies. Longitudinal studies analyzing the effect of advanced PD treatment on life and treatment satisfaction are warranted.



2016 ◽  
Vol 29 ◽  
pp. 104-108 ◽  
Author(s):  
Aristide Merola ◽  
Alberto J. Espay ◽  
Alberto Romagnolo ◽  
Andrea Bernardini ◽  
Laura Rizzi ◽  
...  




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