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  • Year in Review
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PARKINSON DISEASE IN 2018

New therapeutic developments for Parkinson disease

Nature Reviews Neurology volume 15, pages 68–69 (2019)Cite this article

Subjects

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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References

  1. Berg, D. et al. Movement disorder society criteria for clinically established early Parkinson’s disease. Mov. Disord. 33, 1643–1646 (2018).

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  2. Postuma, R. B. et al. Validation of the MDS clinical diagnostic criteria for Parkinson’s disease. Mov. Disord. 33, 1601–1608 (2018).

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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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  5. Athauda, D. et al. Post hoc analysis of the exenatide-PD trial-factors that predict response. Eur. J. Neurosci. https://doi.org/10.1111/ejn.14096 (2018).

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  8. Lhommee, E. et al. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson’s disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial. Lancet Neurol. 17, 223–231 (2018).

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  9. Elias, W. J. A trial of focused ultrasound thalamotomy for essential tremor. N. Engl. J. Med. 375, 2202–2203 (2016).

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  10. Martinez-Fernandez, R. et al. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson’s disease: a pilot study. Lancet Neurol. 17, 54–63 (2018).

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Author information

Authors and Affiliations

  1. Department of Neurology, Christian-Albrechts-University, Kiel, Germany

    Günther Deuschl

  2. Department of Neurology, Academic Medical Center, Amsterdam, Netherlands

    Rob M. A. de Bie

Authors
  1. Günther Deuschl
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  2. Rob M. A. de Bie
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Corresponding author

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. R.M.A.de 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). https://doi.org/10.1038/s41582-019-0133-0

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