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New therapeutic developments for Parkinson disease

In 2018, developments in Parkinson disease (PD) research yielded improved diagnostic criteria and provided evidence for the effects of some treatments, both old and new. These developments enrich the treatment options available for PD and are likely to change important guideline recommendations.

Key advances

  • The new diagnostic criteria for Parkinson disease (PD) yield high diagnostic specificity, but modest sensitivity2.

  • Although many drugs have failed to protect against disease progression in trials, exenatide is a promising new candidate5.

  • Subcutaneous infusion of apomorphine, a dopamine agonist, shortens the off-time of patients with advanced PD according to a confirmatory double-blind study6.

  • A secondary analysis of a trial testing deep brain stimulation of the subthalamic nucleus against the best available medical treatment has shown that it improves impulse control disorders8.

  • Pulsed focused ultrasound lesioning, an invasive procedure without incision, was successfully used in the subthalamic nucleus as a treatment of PD with motor response fluctuations10.

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  3. Athauda, D. et al. Exenatide once weekly versus placebo in Parkinson’s disease: a randomised, double-blind, placebo-controlled trial. Lancet 390, 1664–1675 (2017).

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Correspondence to Günther Deuschl.

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Competing interests

G.D. has received lecture fees from Boston Scientific and has been serving as a consultant for Boston Scientific. He received royalties from Thieme publishers. He is a government employee and receives through his institution funding for his research from the German Research Council, the German Ministry of Education and Research and Medtronic. B. reports grants from ZonMw, Parkinson Vereniging (Netherlands patient organization), Stichting ParkinsonFonds (charitable foundation) and Stichting Parkinson Nederland (charitable foundation), and unrestricted research grants from GE Health and from Medtronic.

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Deuschl, G., de Bie, R.M.A. New therapeutic developments for Parkinson disease. Nat Rev Neurol 15, 68–69 (2019).

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