Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

PARKINSON DISEASE IN 2018

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.

This is a preview of subscription content

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

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

    Article  Google Scholar 

  2. 2.

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

    CAS  Article  Google Scholar 

  3. 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).

    CAS  Article  Google Scholar 

  4. 4.

    Athauda, D. et al. What effects might exenatide have on non-motor symptoms in Parkinson’s disease: a post hoc analysis. J. Parkinsons Dis. 8, 247–258 (2018).

    CAS  Article  Google Scholar 

  5. 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).

    Article  PubMed  Google Scholar 

  6. 6.

    Katzenschlager, R. et al. Apomorphine subcutaneous infusion in patients with Parkinson’s disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Neurol. 17, 749–759 (2018).

    CAS  Article  Google Scholar 

  7. 7.

    Corvol, J. C. et al. Longitudinal analysis of impulse control disorders in Parkinson disease. Neurology 91, e189–e201 (2018).

    CAS  Article  Google Scholar 

  8. 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).

    Article  Google Scholar 

  9. 9.

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

    Article  Google Scholar 

  10. 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).

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Günther Deuschl.

Ethics declarations

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.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing