Update on the intensified therapies for the advanced stages of idiopathic Parkinson's disease

Idiopathic Parkinson's disease is a heterogeneous neurodegenerative disorder. While conservative therapies are very effective in the early stages of the disease, advanced stages of with motor complications demand more invasive methods like deep brain stimulation or pump-based infusion of L-DOPA and apomorphine. In the last decades, clinical experience and evidence on these therapies were established that considerably improve the patient's quality of life even in advanced Parkinson's disease. The choice for the right therapy remains complex for both the patient and the neurologist. However, the early identification and discussion of the indications with the patients and their caregivers are possible and needed outside of specialized centres. Here we provide an up-to-date overview of the different therapy options and their individual characteristics.