The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease

doi:10.1186/s40035-016-0059-z

Review

. 2016 Jun 30:5:12.

doi: 10.1186/s40035-016-0059-z. eCollection 2016.

The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease

Shengdi Chen¹, Piu Chan², Shenggang Sun³, Haibo Chen⁴, Baorong Zhang⁵, Weidong Le⁶, Chunfeng Liu⁷, Guoguang Peng⁸, Beisha Tang⁹, Lijuan Wang¹⁰, Yan Cheng¹¹, Ming Shao¹², Zhenguo Liu¹³, Zhenfu Wang¹⁴, Xiaochun Chen¹⁵, Mingwei Wang¹⁶, Xinhua Wan¹⁷, Huifang Shang¹⁸, Yiming Liu¹⁹, Pingyi Xu²⁰, Jian Wang²¹, Tao Feng²², Xianwen Chen²³, Xingyue Hu²⁴, Anmu Xie²⁵, Qin Xiao¹

Affiliations

¹ Department of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
² Xuanwu Hospital affiliated to Capital Medical University, Beijing, China.
³ Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁴ Beijing Hospital, Beijing, China.
⁵ The Second Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
⁶ The First Hospital affiliated to Dalian Medical University, Dalian, China.
⁷ The Second Affiliated Hospital of Soochow University, Suzhou, China.
⁸ The First Hospital affiliated to Chongqing Medical University, Chongqing, China.
⁹ Xiangya Hospital, Central South University, Changsha, China.
¹⁰ Guangdong General Hospital, Guangzhou, China.
¹¹ General Hospital affiliated to Tianjin Medical University, Tianjin, China.
¹² Sichuan Rehabilitation Hospital, Chengdu, China.
¹³ Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁴ Chinese PLA General Hospital, Beijing, China.
¹⁵ Fujian Medical University Union Hospital, Fuzhou, China.
¹⁶ The First Hospital affiliated to Hebei Medical University, Shijiazhuang, China.
¹⁷ Peking Union Medical College Hospital, Beijing, China.
¹⁸ West China Hospital affiliated to Sichuan University, Chengdu, China.
¹⁹ Qilu Hospital affiliated to Shandong University, Jinan, China.
²⁰ The First Hospital affiliated to Guangzhou Medical University, Guangzhou, China.
²¹ Huashan Hospital affiliated to Fudan University, Shanghai, China.
²² Tiantan Hospital affiliated to Capital Medical University, Beijing, China.
²³ The First Hospital affiliated to Anhui Medical University, Hefei, China.
²⁴ Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
²⁵ The Affiliated Hospital, Qingdao University School of Medicine, Qingdao, China.

PMID: 27366321
PMCID: PMC4928283
DOI: 10.1186/s40035-016-0059-z

Review

The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease

Shengdi Chen et al. Transl Neurodegener. 2016.

. 2016 Jun 30:5:12.

doi: 10.1186/s40035-016-0059-z. eCollection 2016.

Authors

Affiliations

¹ Department of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
² Xuanwu Hospital affiliated to Capital Medical University, Beijing, China.
³ Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁴ Beijing Hospital, Beijing, China.
⁵ The Second Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
⁶ The First Hospital affiliated to Dalian Medical University, Dalian, China.
⁷ The Second Affiliated Hospital of Soochow University, Suzhou, China.
⁸ The First Hospital affiliated to Chongqing Medical University, Chongqing, China.
⁹ Xiangya Hospital, Central South University, Changsha, China.
¹⁰ Guangdong General Hospital, Guangzhou, China.
¹¹ General Hospital affiliated to Tianjin Medical University, Tianjin, China.
¹² Sichuan Rehabilitation Hospital, Chengdu, China.
¹³ Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁴ Chinese PLA General Hospital, Beijing, China.
¹⁵ Fujian Medical University Union Hospital, Fuzhou, China.
¹⁶ The First Hospital affiliated to Hebei Medical University, Shijiazhuang, China.
¹⁷ Peking Union Medical College Hospital, Beijing, China.
¹⁸ West China Hospital affiliated to Sichuan University, Chengdu, China.
¹⁹ Qilu Hospital affiliated to Shandong University, Jinan, China.
²⁰ The First Hospital affiliated to Guangzhou Medical University, Guangzhou, China.
²¹ Huashan Hospital affiliated to Fudan University, Shanghai, China.
²² Tiantan Hospital affiliated to Capital Medical University, Beijing, China.
²³ The First Hospital affiliated to Anhui Medical University, Hefei, China.
²⁴ Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
²⁵ The Affiliated Hospital, Qingdao University School of Medicine, Qingdao, China.

PMID: 27366321
PMCID: PMC4928283
DOI: 10.1186/s40035-016-0059-z

Abstract

Background: Parkinson's disease (PD) is a chronic, progressive and debilitating disease, which affects over 2.5 million people in China. PD is characterized clinically by resting tremor, muscular rigidity, bradykinesia and postural instability. As the disease progresses, additional complications can arise such as non-motor and neurobehavioral symptoms. Pharmacological treatment and surgical intervention for PD have been implemented in China. Until 10 years ago, there was lack of standardization for the management of PD in different regions and among different physicians, leading to different treatment levels in different regions and different physicians. Since then, the Chinese Parkinson's Disease and Movement Disorder Society have published three versions of guidelines for the management of PD in China, in 2006, 2009 and 2014, respectively. Correspondingly, the overall level of treatment for PD in China improved.

Objectives: To update the treatment guidelines based on current foreign and domestic practice guidelines and clinical evidence, and to improve the treatment options available to physicians in the management of PD.

Summary: A variety of treatment recommendations in the treatment guidelines have been proposed, including physical activity and disease-modifying medication, which should be initiated at the early-stage of the disease. The principles of dosage titration should be followed to avoid acute adverse reactions to the drugs, to achieve a satisfactory clinical effect with a low dose and to reduce the incidence of long-term motor complications. Moreover, different treatment strategies should be considered at different stages of the disease. Importantly, treatment guidelines and personalized treatments should be valued equally. A set of treatment recommendations has been developed to assist physicians to improve and optimize clinical outcomes for patients with PD in China.

Keywords: Parkinson’s disease; Treatment guideline, optimal therapeutic options, China.

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Figures

**Fig. 1**
Pathway for monotherapy in early Parkinson’s disease

**Fig. 2**
Pathway for combined therapy in early Parkinson’s disease

See this image and copyright information in PMC

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References

1. Zhang Z-X, Roman GC, Hong Z, Wu C-B, Qu Q-M, Huang J-B, Zhou B, Geng Z-P, Wu J-X, Wen H-B, Zhao H, Zahner GEP. Parkinson’s disease in China: prevalence in Beijing, Xian, and Shanghai. Lancet. 2005;365:595–7. - PubMed
1. Ma CL, Su L, Xie JJ, Long JX, Wu P, Gu L. The prevalence and incidence of Parkinson’s disease in China: a systematic review and meta-analysis. J Neural Transm (Vienna) 2014;121:123–34. doi: 10.1007/s00702-013-1092-z. - DOI - PubMed
1. Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015;386:896–912. doi: 10.1016/S0140-6736(14)61393-3. - DOI - PubMed
1. Chaudhuri KR, Healy DG, Schapira AHV. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol. 2006;5:235–45. doi: 10.1016/S1474-4422(06)70373-8. - DOI - PubMed
1. Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8:464–74. doi: 10.1016/S1474-4422(09)70068-7. - DOI - PubMed

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[1] Zhang Z-X, Roman GC, Hong Z, Wu C-B, Qu Q-M, Huang J-B, Zhou B, Geng Z-P, Wu J-X, Wen H-B, Zhao H, Zahner GEP. Parkinson’s disease in China: prevalence in Beijing, Xian, and Shanghai. Lancet. 2005;365:595–7. - PubMed

[2] Zhang Z-X, Roman GC, Hong Z, Wu C-B, Qu Q-M, Huang J-B, Zhou B, Geng Z-P, Wu J-X, Wen H-B, Zhao H, Zahner GEP. Parkinson’s disease in China: prevalence in Beijing, Xian, and Shanghai. Lancet. 2005;365:595–7. - PubMed

[3] Ma CL, Su L, Xie JJ, Long JX, Wu P, Gu L. The prevalence and incidence of Parkinson’s disease in China: a systematic review and meta-analysis. J Neural Transm (Vienna) 2014;121:123–34. doi: 10.1007/s00702-013-1092-z. - DOI - PubMed

[4] Ma CL, Su L, Xie JJ, Long JX, Wu P, Gu L. The prevalence and incidence of Parkinson’s disease in China: a systematic review and meta-analysis. J Neural Transm (Vienna) 2014;121:123–34. doi: 10.1007/s00702-013-1092-z. - DOI - PubMed

[5] Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015;386:896–912. doi: 10.1016/S0140-6736(14)61393-3. - DOI - PubMed

[6] Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015;386:896–912. doi: 10.1016/S0140-6736(14)61393-3. - DOI - PubMed

[7] Chaudhuri KR, Healy DG, Schapira AHV. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol. 2006;5:235–45. doi: 10.1016/S1474-4422(06)70373-8. - DOI - PubMed

[8] Chaudhuri KR, Healy DG, Schapira AHV. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol. 2006;5:235–45. doi: 10.1016/S1474-4422(06)70373-8. - DOI - PubMed

[9] Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8:464–74. doi: 10.1016/S1474-4422(09)70068-7. - DOI - PubMed

[10] Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8:464–74. doi: 10.1016/S1474-4422(09)70068-7. - DOI - PubMed

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The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease

Affiliations

The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease

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