Late-Stage Parkinson’s Patients Find New Hope in Treatment Changes, TUM Study Shows

A team led by Prof. Paul Lingor has examined data from 22 German Parkinson’s centers. The result: although there are several options for therapies in the late stages of the disease, rarely is more than one used – although those affected often benefit from them.

(IN BRIEF) A recent study led by the Technical University of Munich (TUM) reveals that late-stage Parkinson’s disease patients may benefit from changes in treatment, even after invasive therapies have been attempted. The study analyzed data from 22 German Parkinson’s centers and found that altering or combining advanced treatments could lead to improved mobility and quality of life. The findings challenge the belief that all treatment options are exhausted in the late stages of the disease. Researchers aim to establish a Germany-wide registry to develop evidence-based guidelines for combining advanced treatments for Parkinson’s patients.

(PRESS RELEASE) MUNICH, 6-Nov-2023 — /EuropaWire/ — Innovative research led by Technical University of Munich (TUM), one of Europe’s leading universities with focus on the engineering sciences, natural sciences, life sciences, medicine, and social sciences, highlights the potential for improved treatment outcomes in late-stage Parkinson’s disease. Typically, as the disease progresses, patients may undergo invasive therapies, including brain surgery, when standard treatments are no longer effective. However, a new study reveals that changing treatment approaches can still offer benefits in such cases, a practice currently underutilized.

Prof. Paul Lingor led a research team that analyzed data from 22 German Parkinson’s centers, uncovering that although multiple therapies exist for late-stage patients, they are seldom combined or switched. The study indicates that many patients could experience improved outcomes if these advanced treatments were adjusted or combined.

Parkinson’s disease ranks as the second-most common neurodegenerative disease globally, after Alzheimer’s, and currently has no cure. Treatment typically involves alleviating symptoms with medications in early stages. However, as the disease advances, these medications may become insufficient.

Invasive treatments, like deep brain stimulation and drug pump technology, are then considered. These treatments can be costly and vary in invasiveness, with some involving surgical implantation of brain electrodes or automated drug infusions. Despite these advanced approaches, they may not consistently deliver desired results or lose effectiveness over time.

The reluctance to change or combine treatments has led to the belief that all options are exhausted, impacting patients’ quality of life and life expectancy.

Data from 22 Parkinson’s Centers The study, co-authored by Dr. Dominik Pürner, analyzed data from 22 German Parkinson’s centers over a 16-year period, focusing on patients who switched or combined advanced treatments. The research found that the majority of these interventions led to subjective and objective improvements in mobility.

“Among the approximately 11,000 people undergoing advanced treatments at those centers during the study period, we were able to identify 116 persons in which advanced treatments were replaced or combined with an additional method,” says first author Dr. Dominik Pürner. Because some patients underwent more than one change in treatment, the researchers were able to analyze a total of 148 cases. The analysis of the data shows that most of these interventions were successful. For example, the physicians and patients reported a subjective improvement in mobility that was also reflected in objective tests.

Notably, the study calls attention to the potential for changing treatments to be as effective as initial treatments, offering significant benefits to patients. Previous research on this topic is limited, both in Germany and globally, making this study a valuable contribution to the field.

Recommendation for Action The findings suggest that when advanced treatments fail to produce desired results, a change in treatment should be considered. This insight challenges the notion that all available treatments are futile at an advanced stage of the disease.

The researchers aim to establish a Germany-wide registry of Parkinson’s patients undergoing device-based treatments in the future. This registry will enable the development of evidence-based guidelines for combining advanced treatments, improving the care of late-stage Parkinson’s patients.

“With people living longer, we will be faced more and more often with the question of what we can do for people when an advanced treatment fails,” says Paul Lingor. “We were able to show: The improvement for patients from a change in treatments is almost the same as when the original treatment is introduced. This is an enormous benefit.” Very few studies on changes in treatment have taken place to date in Germany or other countries. The researchers believe that their study has greatly improved the data situation, making it easier, for example, to determine which patient groups will benefit more from which strategy. This makes it possible to select a change in treatments on the basis of the dominant complaints.

“Based on the results of our study, we can now make a clear recommendation for action,” says Paul Lingor. “If an advanced treatment does not produce results or bring about the desired effects, a change in treatment should be considered. This insight is far from trivial, because it would have been entirely possible that all available treatments would fail at an advanced stage of the disease.” In the future the researchers wish to set up a Germany-wide registry including the data of all Parkinson’s patients undergoing device-based treatments in order to develop scientifically sound guidelines for the combination of advanced treatments.