Device-assisted treatments for Parkinson's disease have revolutionized the management of this progressive neurological disorder, offering significant improvements in symptom control and quality of life. The role of neurologists is essential in the implementation and management of these device-assisted therapies. Neurologists evaluate patients' suitability for such interventions through detailed clinical evaluations and diagnostic tests. After implementation, neurologists are responsible for fine-tuning the devices, adjusting settings to optimize therapeutic outcomes, and monitoring patients for potential side effects or complications. Through regular monitoring and ongoing management, neurologists ensure that patients get the most benefit from these advanced treatment methods, greatly enhancing their ability to effectively manage their Parkinson's disease.
Η The Apomorphine Pump and Duodopa Pump are advanced device-assisted therapies designed to continuously administer medication. The apomorphine pump delivers apomorphine, a dopamine agonist, subcutaneously at specific times during the day. This method helps maintain stable levels of dopamine in the brain, thereby reducing motor fluctuations and "off" periods when the patient's symptoms are not adequately controlled with oral medications. Apomorphine is particularly useful for patients who experience severe and unpredictable movement fluctuations and for those who have difficulty swallowing pills. The continuous infusion provided by the pump ensures a more consistent therapeutic effect, improving overall mobility and quality of life.
The Duodopa pump, on the other hand, delivers a gel form of levodopa and carbidopa directly into the small intestine through a percutaneous endoscopic gastrostomy with a catheter in the jejunum (PEG-J). This direct delivery bypasses the stomach, leading to more stable levodopa plasma concentrations. By maintaining stable drug levels, the Duodopa Pump minimizes motor fluctuations and dyskinesia associated with oral levodopa therapy. It is particularly beneficial for patients in advanced stages of Parkinson's disease who experience significant "off" periods and unpredictable response to oral medications.
Both apomorphine and Duodopa pumps require careful patient selection, education and regular monitoring by healthcare professionals to adjust doses and monitor for potential side effects, ensuring optimal management of Parkinson's disease symptoms.
At our center we have the opportunity to recommend the above described treatments, to implement them in collaboration with specific centers and to subsequently regulate and monitor the treatment response of these patients.
