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Review
. 2022 Sep 23:9:863921.
doi: 10.3389/fsurg.2022.863921. eCollection 2022.

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

Stephanie N Serva  1 , Jacob Bernstein  2 , John A Thompson  2   3 , Drew S Kern  2   3 , Steven G Ojemann  2   3
Affiliations
Review

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

Stephanie N Serva et al. Front Surg. .

Abstract

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.

Keywords: Parkinson's disease; advanced therapies; deep brain stimulation; focused ultrasound; gene therapy; movement disorders.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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