[Advanced Parkinson's disease: clinical characteristics and treatment (part 1)]

Abstract

Introduction: A large percentage of patients with Parkinson's disease (PD) develop motor fluctuations, dyskinesias, and severe non-motor symptoms within 3 to 5 years of starting dopaminergic therapy, and these motor complications are refractory to treatment. Several authors refer to this stage of the disease as advanced Parkinson's disease.

Objective: To define the clinical manifestations of advanced PD and the risk factors for reaching this stage of the disease.

Development: This consensus document has been prepared by using an exhaustive literature search and by discussion of the contents by an expert group on movement disorders of the Sociedad Española de Neurología (Spanish Neurology Society), coordinated by two of the authors (JK and MRL).

Conclusions: Severe motor fluctuations and dyskinesias, axial motor symptoms resistant to levodopa, and cognitive decline are the main signs in the clinical phenotype of advanced PD.

Keywords: Advanced Parkinson's disease; Clinical phenotype; Enfermedad de Parkinson avanzada; Escalas de calidad de vida; Escalas de valoración motora; Escalas de valoración no motora; Factores de riesgo; Fenotipo clínico; Motor scales; Non-motor scales; Quality of life scales; Risk factors.