Quality of “on”: a novel therapeutic objective in advanced Parkinson's disease

Fecha de publicación: 01/01/2026

Autores de IIS La Fe

Irene Martínez Torres

Autor

Participantes ajenos a IIS La Fe

Freire-Álvarez E.
Santos-García D.
Escamilla-Sevilla F.
Calopa M.
Carrillo F.
García-Ramos R.
Legarda I.
Martínez-Castrillo J.C.
Gómez-Esteban J.C.

Grupos

Enfermedad de Parkinson y Trastornos del Movimiento

Abstract

Parkinson's disease (PD) is typically managed by dopaminergic supplementation. As the disease progresses, most patients receiving levodopa treatment develop motor and non-motor symptoms that may be managed with therapy modifications. However, in time, they become refractory to conventional medical treatment and require device-aided therapies (DATs). The characterization of “on-off” periods and therapeutic efficacy variables in DATs have received ample attention in the literature, but only limited information is available on variables that affect the well-being of patients during “on” periods unrelated to their duration. In this Point of View article, therefore, we reflected on the concept of the quality of “on” periods — that is to say, the motor and non-motor fluctuating symptoms experienced during “on” time by patients with advanced PD (APD) treated with DATs that must be addressed and defined by acknowledging those issues raised by the patients as essential to their well-being. To explore this definition, a panel of experts in movement disorders met to discuss and subsequently conducted an exhaustive literature search. By this approach, we offer an analysis of symptoms that impact the quality of “on” periods in patients undergoing DATs which may be modifiable with therapy and propose a definition and initial approach to consider the quality of “on” as a therapeutic goal in treating persons with APD. © 2026

Datos de la publicación

ISSN/ISSNe:: 1353-8020, 1873-5126
Tipo:: Note
Páginas:: -
DOI:: 10.1016/j.parkreldis.2026.108391
PubMed:: 42323209
Enlace a otro recurso:: www.scopus.com
Factor de Impacto:: 1,093 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Freire-Álvarez E.:: Hospital General Universitario de Elche, Imed Hospital, Elche, Alicante, Spain
Santos-García D.:: Department of Neurology, A Coruña University Hospital Center (CHUAC), A Coruña, Spain
Escamilla-Sevilla F.:: Movement Disorders Unit, Neurology Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
Calopa M.:: Neurology Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
Carrillo F.:: Movement Disorders Unit, Neurology and Clinical Neurophysiology Service, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain

Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
García-Ramos R.:: Department of Neurology, Institute of Neurosciences, Hospital Clínico San Carlos, Madrid, Spain
Legarda I.:: Hospital Universitario Son Espases, Palma de Mallorca, Spain
Martínez-Torres I.:: Neurology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
Martínez-Castrillo J.C.:: Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
Gómez-Esteban J.C.:: Neurodegenerative diseases, Biocruces Research Institute, Barakaldo, Bizkaia, Spain

Keywords

Apomorphine; Deep brain stimulation; Dyskinesia; Motor fluctuations; Non-motor fluctuations; Parkinson; “On” quality

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