An update on advanced therapies for Parkinson's disease: From gene therapy to neuromodulation

Advanced Parkinson's disease (PD) is characterized by increasingly debilitating impaired movements that include motor fluctuations and dyskinesias. At this stage of the disease, pharmacological management can result in unsatisfactory clinical benefits and increase the occurrence of adverse effe...

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Published inFrontiers in surgery Vol. 9; p. 863921
Main Authors Serva, Stephanie N., Bernstein, Jacob, Thompson, John A., Kern, Drew S., Ojemann, Steven G.
Format Journal Article
LanguageEnglish
Published Frontiers Media S.A 23.09.2022
Subjects
advanced therapies
deep brain stimulation
focused ultrasound
gene therapy
movement disorders
Parkinson's disease
Surgery
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Summary:Advanced Parkinson's disease (PD) is characterized by increasingly debilitating impaired movements that include motor fluctuations and dyskinesias. At this stage of the disease, pharmacological management can result in unsatisfactory clinical benefits and increase the occurrence of adverse effects, leading to the consideration of advanced therapies. The scope of this review is to provide an overview of currently available therapies for advanced PD, specifically levodopa–carbidopa intestinal gel, continuous subcutaneous apomorphine infusion, radiofrequency ablation, stereotactic radiosurgery, MRI-guided focused ultrasound, and deep brain stimulation. Therapies in clinical trials are also discussed, including novel formulations of subcutaneous carbidopa/levodopa, gene-implantation therapies, and cell-based therapies. This review focuses on the clinical outcomes and adverse effects of the various therapies and also considers patient-specific characteristics that may influence treatment choice. This review can equip providers with updated information on advanced therapies in PD to better counsel patients on the available options.
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Edited by: Ricardo Santos De Oliveira, University of São Paulo, Brazil
Reviewed by: Luciano Furlanetti, King's College London, United Kingdom Hiroki Toda, Kitano Hospital, Japan Caio M. Matias, Thomas Jefferson University, United States
Specialty Section: This article was submitted to Neurosurgery, a section of the journal Frontiers in Surgery
ISSN:2296-875X
2296-875X
DOI:10.3389/fsurg.2022.863921