Parkinson Platform Noord Nederland

Oral levodopa plus a dopa-decarboxylase inhibitor (LD-DCI) is the standard of care for Parkinson's disease. However, within 5 years of starting treatment, about 50% of patients develop debilitating off episodes, during which motor and non-motor symptoms reappear. The addition of a dopamine agonist, amine oxidase (flavin-containing) B inhibitor, or catechol-O-methyltransferase inhibitor partly reduces daily duration of off episodes, but some patients remain impaired to a point that justifies the use of complex, aggressive, expensive, and inconvenient device-based therapies.