{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:27:54Z","timestamp":1786512474016,"version":"build-2736575974"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parkinson\u2019s disease (PD) incidence has risen by more than eightfold in the United Arab Emirates (UAE) between 1990 and 2019, representing one of the highest increases globally and creating substantial pressure on a fragmented, multi-payer health system. Region-specific guidance has been lacking, leading clinicians to extrapolate from international guidelines that do not fully address formulary heterogeneity, advanced therapy centralization, and cultural factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Under the auspices of the Emirates Neurology Society, a national taskforce of 10 specialists representing major PD centers across the UAE used a three-round modified Delphi process informed by systematic literature review and key randomized controlled trials. Recommendations were graded using a GRADE-aligned system (A-C, Good Practice Points) and adapted to UAE formulary, service configuration, and cultural context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was achieved on 146 recommendations across eight domains: (1) mandatory adoption of MDS-2015 diagnostic criteria; (2) age-stratified pharmacologic algorithms with levodopa as first-line for older or cognitively vulnerable patients; (3) structured non-motor symptom management; (4) rehabilitation and UAE cultural lifestyle adaptations including Ramadan fasting management, DBS considerations in women, family-centered care, and multilingual practice; (5) advanced therapy referral using the 5\u20132-1 rule integrated with the Making Informed Decisions to Aid Timely Management of Parkinson\u2019s Disease (MANAGE-PD) tool, with five device-aided options (subcutaneous foslevodopa\/foscarbidopa, apomorphine SC- subcutanous, LCIG- Levodopa Carbidopa Intestinal Gel, DBS- Deep Brain Stimulation, MRgFUS- MRI guided focussed ultrasound) presented through shared decision-making; (6) a three-tier service model; (7) UAE formulary mapping; and (8) center accreditation and registry metrics. Advanced therapies are centralized in accredited centers with clear minimum volume and multidisciplinary staffing criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These UAE consensus recommendations provide a pragmatic, context-adapted framework for PD management, emphasizing structured diagnosis, age-appropriate pharmacotherapy, systematic use of MANAGE-PD and 5-2-1 for advanced therapy referral, culturally sensitive practice adaptations, and a three-tier network model integrated through the Malaffi health information exchange and a planned national PD registry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1859775","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:40:12Z","timestamp":1786509612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Parkinson\u2019s disease in the United Arab Emirates (UAE): Emirates Neurology Society consensus guidelines"],"prefix":"10.3389","volume":"17","author":[{"given":"Shivam Om","family":"Mittal","sequence":"first","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center, Neurological Institute, Cleveland Clinic Abu Dhabi","place":["Abu Dhabi, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Iantorno","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital London","place":["Dubai, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hassan","sequence":"additional","affiliation":[{"name":"Tawam Hospital","place":["Al Ain, United Arab Emirates"]},{"name":"Sh. Tahnoon Bin Mohammed Medical City","place":["Al Ain, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Krystkowiak","sequence":"additional","affiliation":[{"name":"Specialized Rehabilitation Hospital","place":["Abu Dhabi, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pournamy","family":"Sarathchandran","sequence":"additional","affiliation":[{"name":"University Hospital Sharjah","place":["Sharjah, United Arab Emirates"]},{"name":"Al Qassimi Hospital Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl Johan","family":"Ramberg","sequence":"additional","affiliation":[{"name":"Sheikh Khalifa Medical City Ajman","place":["Ajman, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alolama","sequence":"additional","affiliation":[{"name":"University Hospital Sharjah","place":["Sharjah, United Arab Emirates"]},{"name":"Rashid Hospital","place":["Dubai, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanmoy","family":"Maiti","sequence":"additional","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center, Neurological Institute, Cleveland Clinic Abu Dhabi","place":["Abu Dhabi, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Cirasanambati","sequence":"additional","affiliation":[{"name":"Burjeel Medical City","place":["Abu Dhabi, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazin Yousif","family":"Alsafi","sequence":"additional","affiliation":[{"name":"International University of Africa","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhail","family":"Al Rukn","sequence":"additional","affiliation":[{"name":"Sheikh Khalifa Medical City Ajman","place":["Ajman, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e080952","DOI":"10.1136\/bmj-2024-080952","article-title":"Projections for prevalence of Parkinson\u2019s disease and its driving factors in 195 countries and territories to 2050: modelling study of global burden of disease study 2021","volume":"388","author":"Su","year":"2025","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s12889-022-14780-8","article-title":"The burden of Parkinson\u2019s disease in the Middle East and North Africa region, 1990\u20132019: results from the global burden of disease study 2019","volume":"23","author":"Safiri","year":"2023","journal-title":"BMC Public 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