Use of telemedicine |
|
Optimization of motor and non-motor symptoms [19] |
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Adjustments for medication-related side effects [19] |
|
Reliable to assess Motor section of the Unified Parkinson’s Disease Rating Scale (UPDRS-III) [25] |
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Speech therapy, physiotherapy and rehabilitation services [30] |
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Alternatives: Wearable devices and smartphone applications, or Phone calls or patient-recorded videos, sent via text messaging |
Deep brain stimulation surgery (DBS)/therapy |
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Selective DBS for PD patients with urgent indication |
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Post-operative follow-up for suture removal and stimulation settings should be timed appropriately |
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Urgent intervention for end of battery life of the implantable pulse generator, leads fracture and infection related to lead implantation [23,25,31,32] |
Medications |
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Caution of drug interaction with PD medication [33] |
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Avoid abrupt cessation of PD medications [31] |
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Highly fractionated doses of levodopa solution can be given via a nasogastric tube [31] |
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Apomorphine pump therapy and levodopa/carbidopa intestinal gel (LCIG) continuous infusion can be continued [31] |
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Intravenous amantadine is less efficacious [31] |
|
Sequential withdrawal of anticholinergics, MAO-B inhibitors and COMT-I is recommended for psychosis and delirium related to infection |
Sequelae of Parkinsonism in COVID-19 |
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The need of proper registry for prevalence/incidence |
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The use of biomarker (e.g., neurofilament light chain for signs of neurodegeneration [40]) |
Vaccination |
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Recommended in PD patients [42] |
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Do not interfere with the current PD medication [42] |
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Not known to interact with the neurodegenerative process in PD [42] |
Research |
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Non-clinical or clinical studies without direct contact with patients should be prioritized [46] |
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Encourage studies related to preventive, diagnostic and interventional measures [47] |
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Enhance the international collaboration in PD research [47] |
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Application of artificial Intelligence with an integrated-omics approach [49,50] |