Abstract
Parkinson's disease (PD) is a chronic neurologic disease that has a great impact on the patient’s quality of life. The natural course of the disease is characterized by an insidious onset of symptoms, such as rest tremor, shuffling gait, bradykinesia, followed by improvement with the initiation of dopaminergic therapy. However, this “honeymoon period” gradually comes to an end with the emergence of motor fluctuations and dyskinesia. PD patients need long-term treatments and monitoring throughout the day; however, clinical examinations in hospitals are often not sufficient for optimal management of the disease. Technology-based devices are a new comprehensive assessment method of PD patient’s symptoms that are easy to use and give unbiased measurements. This review article provides an exhaustive overview of motor complications of advanced PD and new approaches to the management of the disease using sensors.
Highlights
Parkinson’s disease (PD) is a chronic neurologic disease that has a great impact on the patient’s quality of life
A combination of disease progression and fluctuating L-dopa levels lead to the motor complications of PD [1]
Long-duration response keeps the positive effect of L-dopa beyond the normal halflife of the individual dose: this kind of response usually dominates in early PD
Summary
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor symptoms, such as bradykinesia, tremors, and rigidity. Stocchi et al reported that the majority of PD the disease progresses, patients experience frequent OFF periods, which usually occur in patients with motor fluctuations suffered from delays in ON time (latency >30 min) the late afternoon or early evening This “end-of-the-day crash” represents a predictable following their first morning dose of L-dopa. Nausea is known to be a common problem at the beginning of dopaminergic therapy, but patients with advanced PD may have nausea after each high dose of L-dopa in association with the peak plasma concentration This clinical sign appears only with the first dose of the day, but it can occur with every dose or worsen with each successive dose throughout the day [36]. Patients with PD are able to eliminate only 47% of daily volume in the daytime and 57% at night [56]
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