TY  - JOUR
AU  - Reese, René
AU  - Koeglsperger, Thomas
AU  - Schrader, Christoph
AU  - Tönges, Lars
AU  - Deuschl, Günther
AU  - Kühn, Andrea
AU  - Krack, Paul
AU  - Schnitzler, Alfons
AU  - Storch, Alexander
AU  - Trenkwalder, Claudia
AU  - Höglinger, Günter U
TI  - Invasive therapies for Parkinson's disease: an adapted excerpt from the guidelines of the German Society of Neurology.
JO  - Journal of neurology
VL  - 272
IS  - 3
SN  - 0367-004X
CY  - [Darmstadt]
PB  - Steinkopff
M1  - DZNE-2025-00339
SP  - 219
PY  - 2025
AB  - Parkinson's disease (PD) is characterized by hypokinetic motor symptoms, tremor, and various non-motor symptoms with frequent fluctuations of symptoms in advanced disease stages. Invasive therapies, such as deep brain stimulation (DBS), ablative therapies, and continuous subcutaneous or intrajejunal delivery of dopaminergic drugs via pump therapies are available for the management of this complex motor symptomatology and may also impact non-motor symptoms. The recent update of the clinical guideline on PD by the German Neurological Society (Deutsche Gesellschaft für Neurologie e.V.; DGN) offers clear guidance on the indications and applications of these treatment options.The guideline committee formulated diagnostic questions for invasive therapies and structured them according to the PICOS framework (Population-Intervention-Comparisons-Outcome-Studies). A systematic literature review was conducted. Questions were addressed using the findings from the literature review and consented by the guideline committee.Specific recommendations are given regarding (i) the optimal timing for starting invasive therapies, (ii) the application of DBS, (iii) the use of pump therapies in advanced PD, (iv) the indications for ablative procedures, and (iv) selecting the most appropriate therapy according to individual patient characteristics.This review is an adapted excerpt of the chapters on the use of invasive therapies in PD of the novel German guideline on PD. Clear recommendations on the use of treatment options for advanced PD are provided.
KW  - Humans
KW  - Parkinson Disease: therapy
KW  - Deep Brain Stimulation: standards
KW  - Neurology: standards
KW  - Neurology: methods
KW  - Germany
KW  - Practice Guidelines as Topic: standards
KW  - Societies, Medical: standards
KW  - Ablation (Other)
KW  - Deep brain stimulation (DBS) (Other)
KW  - Invasive therapies (Other)
KW  - Parkinson’s disease (Other)
KW  - Pump therapy (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:39985674
C2  - pmc:PMC11846738
DO  - DOI:10.1007/s00415-025-12915-6
UR  - https://pub.dzne.de/record/276826
ER  -