Abstract

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.

中文翻译：

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帕金森病患者先进疗法的选择：为什么、什么以及何时？

摘要

当口服多巴胺能药物在治疗帕金森病方面表现不佳时，患者会出现运动反应波动和运动障碍，这可能对日常生活的功能产生很大影响。他们可能受益于目前可用的一种先进治疗方法，即深部脑刺激、连续左旋多巴-卡比多巴肠凝胶和连续皮下阿扑吗啡输注。适应症、单独的高级治疗之间的选择和时机可能具有挑战性，将在疾病的进行性、疾病表现的异质性和可变的患者特征的背景下进行讨论。