TY - JOUR
T1 - An Overview of a Stepped-care Approach to Modern Holistic and Subtype-driven Care for Parkinson’s Disease in the Clinic
AU - Popławska-Domaszewicz, Karolina
AU - Falup-Pecurariu, Cristian
AU - Chaudhuri, K. Ray
N1 - Publisher Copyright:
© Touch Medical Media 2024.
PY - 2024/2/22
Y1 - 2024/2/22
N2 - Parkinson’s disease (PD) is not a single disease, and is characterized by a constellation of motor and non-motor symptoms (NMS) with a heterogeneity of pathology, genetic basis and clinical presentation. The clinical phenotypic presentations have been further developed to clinically identify non-motor subtypes or endophenotypes of PD based on specific central neurotransmitter dysfunctions and historical neuropathological data. The successful and complete modern management of PD also includes the care of several "vitals" of PD, consisting of (1) motor symptoms, (2) NMS, (3) vision and oral and gut health, (4) bone health and falls and (5) comorbidities, co-medications and impulse control disorders. Collectively, these domains are rarely assessed in clinics, as there is often a time constraint in busy settings. A recent international survey, assessing the recognition and use of the vitals, showed marked gaps in assessments. A dashboard based on international collaboration and the above-mentioned domains was recently published to help identify the key vitals that should not be overlooked in clinical practice. The vitals dashboard enriches and ensures PD care is complete at all levels, forming the basis of the stepped-care paradigm proposed in this article.
AB - Parkinson’s disease (PD) is not a single disease, and is characterized by a constellation of motor and non-motor symptoms (NMS) with a heterogeneity of pathology, genetic basis and clinical presentation. The clinical phenotypic presentations have been further developed to clinically identify non-motor subtypes or endophenotypes of PD based on specific central neurotransmitter dysfunctions and historical neuropathological data. The successful and complete modern management of PD also includes the care of several "vitals" of PD, consisting of (1) motor symptoms, (2) NMS, (3) vision and oral and gut health, (4) bone health and falls and (5) comorbidities, co-medications and impulse control disorders. Collectively, these domains are rarely assessed in clinics, as there is often a time constraint in busy settings. A recent international survey, assessing the recognition and use of the vitals, showed marked gaps in assessments. A dashboard based on international collaboration and the above-mentioned domains was recently published to help identify the key vitals that should not be overlooked in clinical practice. The vitals dashboard enriches and ensures PD care is complete at all levels, forming the basis of the stepped-care paradigm proposed in this article.
KW - Dashboard
KW - management
KW - non-motor symptoms
KW - nonmotor subtypes
KW - Parkinson’s disease
KW - stepped care
KW - subtype-driven care
KW - vitals
KW - “stepped care” strategy
UR - https://www.scopus.com/pages/publications/85195972183
U2 - 10.17925/USN.2024.20.1.6
DO - 10.17925/USN.2024.20.1.6
M3 - Review article
AN - SCOPUS:85195972183
SN - 2752-5465
VL - 20
SP - 27
EP - 32
JO - touchREVIEWS in Neurology
JF - touchREVIEWS in Neurology
IS - 1
ER -