Invasive therapies for Parkinson’s disease: an adapted excerpt from the guidelines of the German Society of Neurology

Reese, René ; Koeglsperger, Thomas ; Schrader, Christoph; Tönges, Lars; Deuschl, Günther; Kühn, Andrea A.; Krack, Paul; Schnitzler, Alfons; Storch, Alexander; Trenkwalder, Claudia und Höglinger, Günter U. (2025): Invasive therapies for Parkinson’s disease: an adapted excerpt from the guidelines of the German Society of Neurology. In: Journal of Neurology, Bd. 272, 219

Abstract

Background: Parkinson’s disease (PD) is characterized by hypokinetic motor symptoms, tremor, and various non-motor symptoms with frequent fluctuations of symptoms in advanced disease stages. Invasive therapies, such as deep brain stimulation (DBS), ablative therapies, and continuous subcutaneous or intrajejunal delivery of dopaminergic drugs via pump therapies are available for the management of this complex motor symptomatology and may also impact non-motor symptoms. The recent update of the clinical guideline on PD by the German Neurological Society (Deutsche Gesellschaft für Neurologie e.V.; DGN) offers clear guidance on the indications and applications of these treatment options.

Methods: The guideline committee formulated diagnostic questions for invasive therapies and structured them according to the PICOS framework (Population–Intervention–Comparisons–Outcome–Studies). A systematic literature review was conducted. Questions were addressed using the findings from the literature review and consented by the guideline committee.

Results: Specific recommendations are given regarding (i) the optimal timing for starting invasive therapies, (ii) the application of DBS, (iii) the use of pump therapies in advanced PD, (iv) the indications for ablative procedures, and (iv) selecting the most appropriate therapy according to individual patient characteristics.

Conclusion: This review is an adapted excerpt of the chapters on the use of invasive therapies in PD of the novel German guideline on PD. Clear recommendations on the use of treatment options for advanced PD are provided.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy) ; Medizin > Klinikum der LMU München > Neurologische Klinik und Poliklinik mit Friedrich-Baur-Institut
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0340-5354
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198