Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands.
Department of Neurology, James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA.
J Parkinsons Dis. 2020;10(s1):S65-S73. doi: 10.3233/JPD-202104.
When oral dopaminergic medication falls short in the treatment of Parkinson's disease, patients are left with motor response fluctuations and dyskinesias that may have a large impact on functioning in daily life. They may benefit from one of the currently available advanced treatments, namely deep brain stimulation, continuous levodopa-carbidopa intestinal gel, and continuous subcutaneous apomorphine infusion. The indication, choice between the separate advanced treatments and the timing can be challenging and will be discussed against the background of the progressive nature of the disease, the heterogeneity of disease manifestation and variable patient characteristics.
当口服多巴胺能药物在治疗帕金森病方面效果不佳时，患者会出现运动反应波动和运动障碍，这可能会对日常生活中的功能产生重大影响。他们可能会受益于目前可用的先进治疗方法之一，即深部脑刺激、持续左旋多巴-卡比多巴肠凝胶和持续皮下阿扑吗啡输注。该适应症、各种单独的先进治疗方法之间的选择以及治疗时机可能具有挑战性，将根据疾病的进展性质、疾病表现的异质性和患者特征的变化来进行讨论。
