caa a22 4500 44537618X CHVBK 20180317143003.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00702-010-0555-8 doi (NATIONALLICENCE)springer-10.1007/s00702-010-0555-8 What is the best treatment for fluctuating Parkinson's disease: continuous drug delivery or deep brain stimulation of the subthalamic nucleus? [Elektronische Daten] [Rüdiger Hilker, Angelo Antonini, Per Odin] Motor complications impair quality of life and cause severe disability in patients with advanced Parkinson's disease (PD). Since they are often refractory to medical therapy, interventional therapies have been developed, which can provide a considerable reduction of daily off-time and dopaminergic dyskinesias. Continuous dopaminergic drug delivery (CDD) is based on the steady stimulation of striatal dopamine receptors by subcutaneous apomorphine or duodenal l-DOPA infusions via portable minipumps. Advances in the understanding of basal ganglia functioning and in neurosurgical, electrophysiological and neuroimaging techniques have led to a renaissance of neurosurgery for advanced PD. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is the most invasive procedure promising great benefit and the highest level of independency for suitable patients, but is definitely associated with surgical risks and DBS-related side effects. Each of these more or less invasive therapy options has its own profile, and a thorough consideration of its advantages and drawbacks for the individual situation is mandatory. In this paper, we summarize relevant facts for this decision and provide some guidelines for a responsible counseling of eligible patients. Springer-Verlag, 2010 Apomorphine nationallicence Deep brain stimulation nationallicence Duodopa nationallicence Motor fluctuations nationallicence Parkinson's disease nationallicence Hilker Rüdiger Department of Neurology, Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany aut Antonini Angelo RCCS San Camillo Venice, Venice, Italy aut Odin Per Department of Neurology, Lund University Hospital, Sweden and Central Hospital, Bremerhaven, Germany aut Journal of Neural Transmission Springer Vienna 118/6(2011-06-01), 907-914 0300-9564 118:6<907 2011 118 702 https://doi.org/10.1007/s00702-010-0555-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00702-010-0555-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hilker Rüdiger Department of Neurology, Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany aut NATIONALLICENCE 700 1- Antonini Angelo RCCS San Camillo Venice, Venice, Italy aut NATIONALLICENCE 700 1- Odin Per Department of Neurology, Lund University Hospital, Sweden and Central Hospital, Bremerhaven, Germany aut NATIONALLICENCE 773 0- Journal of Neural Transmission Springer Vienna 118/6(2011-06-01), 907-914 0300-9564 118:6<907 2011 118 702 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer