|
Characteristics of patients as proposed by expert-opinion studies |
Motor | Non-motor | Function |
|
(i) Troublesome level of motor fluctuations [29, 30, 58] (ii) At least 1 hour of the day with troublesome dyskinesia [30, 58] (iii) At least 2 hours of the day with “off” time [29, 30, 58] (iv) Off-period postural instability [29, 30] (v) Dystonia with pain [30] (vi) Freezing of gait during “off” time [30] (vii) Daily multiple oral levodopa doses [58] | (i) Non-motor symptom fluctuations [58] (ii) Impulse control disorder [58] Troublesome level of nighttime sleep disturbances [30, 58] (iii) Severe dysphagia and recurrent falls [29] (iv) Troublesome level of daytime sleepiness [58] (v) Troublesome level of anxiety [58] | (i) Needing help with activities of daily living at least some of the time (limited) [29, 30] |
|
Proposed profiles according to clinical characteristics [30] |
Characteristics | Apomorphine | Deep brain stimulation (DBS) | Levodopa carbidopa Intestinal gel (LCIG) |
|
Younger age (<70 years) | Probably good candidate [58] | Probably good candidate [58] | Probably good candidate [58] |
Older age (>70 years) | Probably good candidate [67, 68] | Possible candidate [67, 68] | Probably good candidate [67, 68] |
Good levodopa response | Probably good candidate [58] | Probably good candidate [58] | Definitely good candidate [58] |
Levodopa-resistant tremor | Not a candidate [58, 67] | Definitely good candidate [58, 67] | Not a candidate [58, 67] |
Troublesome dyskinesia | Possible candidate | Probably good candidate [58] | Probably good candidate [58] |
Good cognitive function | Probably good candidate [58] | Probably good candidate [58] | Probably good candidate [58] |
Nighttime sleep disturbances | Possible candidate [58] | Possible candidate [58] | Possible candidate [58] |
Pain | Possible candidate [58] | Possible candidate [58] | Possible candidate [58] |
Impulse control disorder | Not a candidate [58, 67, 68] | Possible candidate [58, 67, 68] | Possible candidate [58, 67, 68] |
Depression | Possible candidate [58, 68] | Not a candidate [58, 68] | Possible candidate [58, 68] |
Apathy | Possible candidate [58] | Not a candidate [58] | Possible candidate [58] |
Anxiety | Not a candidate [58] | Possible candidate [58] | Possible candidate [58] |
Mild dementia | Possible candidate [67, 68] | Not a candidate [67, 68] | Possible candidate [67, 68] |
Multimorbidity | Possible candidate [67]/Not a candidate [68] | Not a candidate [67] | Possible candidate [67]/Not a candidate [68] |
Lack of social support/caregiver | Not a candidate [67] | Possible candidate [67] | Not a candidate [67] |
Excessive daytime sleepiness | Not a candidate [68] | Possible candidate [68] | Possible candidate [68] |
Dysphagia | Probably good candidate [68] | Not a candidate [68] | Probably good candidate [68] |
|