{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:06:11Z","timestamp":1791975971382,"version":"4.4.0"},"reference-count":125,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The decision to choose invasive treatments for Parkinson's disease (PD) is complex and needs careful consideration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although the recommendations of the European Academy of Neurology\/Movement Disorder Society European Section guideline for invasive therapies of PD are useful, the different clinical profiles of people with PD who seek advice for possible invasive therapy need further attention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Here we describe 8 clinical standard situations of people with PD unsatisfied with their current oral treatment where invasive therapies may be considered. These are PD patients presenting with the following symptoms: (1) severe motor fluctuations, (2) beginning of levodopa\u2010responsive fluctuations, severe tremor at (3) young or (4) advanced age, (5) impulse control disorders and related behavioral disorders, (6) hallucinations and psychosis, (7) minimal cognitive impairment or mild dementia, and (8) patients in need of palliative care. For some of these conditions, evidence at lower level or simple clinical considerations exist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are no one\u2010fits\u2010all answers, but physician and patient should discuss each option carefully considering symptom profile, psychosocial context, availability of therapy alternatives, and many other factors. The current paper outlines our proposed approach to these circumstances.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13962","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T01:40:00Z","timestamp":1703554800000},"page":"209-219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["How to Use the New European Academy of Neurology\/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease"],"prefix":"10.1002","volume":"11","author":[{"given":"Dana","family":"Brinker","sequence":"first","affiliation":[{"name":"Department of Neurology UKSH, Christian\u2010Albrechts\u2010University Kiel  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9167-1624","authenticated-orcid":false,"given":"Katarzyna","family":"Smilowska","sequence":"additional","affiliation":[{"name":"Department of Neurology UKSH, Christian\u2010Albrechts\u2010University Kiel  Kiel Germany"},{"name":"Department of Neurology Regional Specialist Hospital im. \u015aw. Barbary  Sonowiec Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9306-8332","authenticated-orcid":false,"given":"Steffen","family":"Paschen","sequence":"additional","affiliation":[{"name":"Department of Neurology UKSH, Christian\u2010Albrechts\u2010University Kiel  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1040-2807","authenticated-orcid":false,"given":"Angelo","family":"Antonini","sequence":"additional","affiliation":[{"name":"Parkinson and Movement Disorders Unit, Study Center for Neurodegenerative Diseases (CESNE), Department of Neuroscience University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Moro","sequence":"additional","affiliation":[{"name":"Grenoble Alpes University, Chu of Grenoble, Division of Neurology Grenoble Institute of Neurosciences  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-9196","authenticated-orcid":false,"given":"G\u00fcnther","family":"Deuschl","sequence":"additional","affiliation":[{"name":"Department of Neurology UKSH, Christian\u2010Albrechts\u2010University Kiel  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00218-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27340"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1502165"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.irn.2017.03.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-019-1276-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15386"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29066"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2012.03866.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12022"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27372"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27602"},{"key":"e_1_2_8_13_1","unstructured":"Sch\u00fcnemannH.Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach; Available from:https:\/\/gdt.gradepro.org\/app\/handbook\/handbook.html2013."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa060281"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.929"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70093-4"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70308-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000250253.03919.fb"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205158"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30108-3"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907083"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70264-8"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70293-X"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28703"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30239-4"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2016311"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)03556-4"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10517"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2202721"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2217\/nmt-2020-0021"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033447"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70151-0"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0145-9"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-021-00223-5"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825dcdc1"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awab074"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.09.018"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-225105"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01747-1"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.12.024"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.06.012"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000082"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.12.003"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13810"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-021-00194-7"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1153-3"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282x20180140"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20955"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awf050"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.6.932"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007037"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.03.019"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009946"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prdoa.2021.100129"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13825"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.02.013"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-013-0378-8"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10163468"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2020.578615"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-019-01216-y"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000206771"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3098"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27637"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.0263"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.10.JNS16758"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.3.JNS19466"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1038\/npjparkd.2016.15"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.09.006"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29569"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-212810"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.5334\/tohm.643"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8803-1"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.65"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-150535"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26164"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30035-8"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-316373"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28320"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26099"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871527319666200720105553"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000091"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12416"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ensci.2017.06.004"},{"key":"e_1_2_8_84_1","article-title":"Treatment of advanced Parkinson's disease","volume":"2010","author":"Varanese S","year":"2011","journal-title":"Parkinsons Dis"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-200825080-00004"},{"key":"e_1_2_8_86_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.19110316"},{"key":"e_1_2_8_87_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.788632"},{"key":"e_1_2_8_88_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27626"},{"key":"e_1_2_8_89_1","doi-asserted-by":"publisher","DOI":"10.1159\/000195719"},{"key":"e_1_2_8_90_1","doi-asserted-by":"publisher","DOI":"10.1097\/wnf.0b013e31814b113e"},{"key":"e_1_2_8_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.09.025"},{"key":"e_1_2_8_92_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22063"},{"key":"e_1_2_8_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2009.05.006"},{"key":"e_1_2_8_94_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26067"},{"key":"e_1_2_8_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.11.013"},{"key":"e_1_2_8_96_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.20040077"},{"key":"e_1_2_8_97_1","article-title":"Management of Psychosis in Parkinson's disease: emphasizing clinical subtypes and pathophysiological mechanisms of the condition","volume":"2017","author":"Taddei RN","year":"2017","journal-title":"Parkinsons Dis"},{"key":"e_1_2_8_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.04.023"},{"key":"e_1_2_8_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.02.020"},{"key":"e_1_2_8_100_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-019-03920-5"},{"key":"e_1_2_8_101_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21956"},{"key":"e_1_2_8_102_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2017.27"},{"key":"e_1_2_8_103_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12391"},{"key":"e_1_2_8_104_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7321-z"},{"key":"e_1_2_8_105_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21478"},{"key":"e_1_2_8_106_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29052"},{"key":"e_1_2_8_107_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12614"},{"key":"e_1_2_8_108_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009822"},{"key":"e_1_2_8_109_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.117063"},{"key":"e_1_2_8_110_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.10.004"},{"key":"e_1_2_8_111_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22450"},{"key":"e_1_2_8_112_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2019.07.024"},{"key":"e_1_2_8_113_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.737"},{"key":"e_1_2_8_114_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25870"},{"key":"e_1_2_8_115_1","volume-title":"Palliative care fact sheet","author":"WHO","year":"2021"},{"key":"e_1_2_8_116_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2019.12.01"},{"key":"e_1_2_8_117_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28556"},{"key":"e_1_2_8_118_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2017.12.02"},{"key":"e_1_2_8_119_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-171181"},{"key":"e_1_2_8_120_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2019.0129"},{"key":"e_1_2_8_121_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12050813"},{"key":"e_1_2_8_122_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00120"},{"key":"e_1_2_8_123_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2019.09.013"},{"key":"e_1_2_8_124_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-202096"},{"key":"e_1_2_8_125_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-019-0098-0"},{"key":"e_1_2_8_126_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-021-02964-6"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:49:58Z","timestamp":1760971798000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":125,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/mdc3.13962"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13962","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]},"assertion":[{"value":"2023-09-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}