title: The recommendations of Chinese Parkinson's disease and movement disorder society consensus on therapeutic management of Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is a chronic, progressive and debilitating disease, which affects over 2.5 million people in China. PD is characterized clinically by resting tremor, muscular rigidity, bradykinesia and postural instability. As the disease progresses, additional complications can arise such as non-motor and neurobehavioral symptoms. Pharmacological treatment and surgical intervention for PD have been implemented in China. Until 10 years ago, there was lack of standardization for the management of PD in different regions and among different physicians, leading to different treatment levels in different regions and different physicians. Since then, the Chinese Parkinson's Disease and Movement Disorder Society have published three versions of guidelines for the management of PD in China, in 2006, 2009 and 2014, respectively. Correspondingly, the overall level of treatment for PD in China improved.
  
  
  OBJECTIVE
  To update the treatment guidelines based on current foreign and domestic practice guidelines and clinical evidence, and to improve the treatment options available to physicians in the management of PD.
  
  
  CONCLUSIONS
  A variety of treatment recommendations in the treatment guidelines have been proposed, including physical activity and disease-modifying medication, which should be initiated at the early-stage of the disease. The principles of dosage titration should be followed to avoid acute adverse reactions to the drugs, to achieve a satisfactory clinical effect with a low dose and to reduce the incidence of long-term motor complications. Moreover, different treatment strategies should be considered at different stages of the disease. Importantly, treatment guidelines and personalized treatments should be valued equally. A set of treatment recommendations has been developed to assist physicians to improve and optimize clinical outcomes for patients with PD in China.
authors.affiliation: Department of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
authors.forename: Shengdi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Xuanwu Hospital affiliated to Capital Medical University, Beijing, China.
authors.forename: Piu
authors.initials: P
authors.lastname: Chan
authors.affiliation: Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shenggang
authors.initials: S
authors.lastname: Sun
authors.affiliation: Beijing Hospital, Beijing, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Chen
authors.affiliation: The Second Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Baorong
authors.initials: B
authors.lastname: Zhang
authors.affiliation: The First Hospital affiliated to Dalian Medical University, Dalian, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Le
authors.affiliation: The Second Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Liu
authors.affiliation: The First Hospital affiliated to Chongqing Medical University, Chongqing, China.
authors.forename: Guoguang
authors.initials: G
authors.lastname: Peng
authors.affiliation: Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Beisha
authors.initials: B
authors.lastname: Tang
authors.affiliation: Guangdong General Hospital, Guangzhou, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang
authors.affiliation: General Hospital affiliated to Tianjin Medical University, Tianjin, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Sichuan Rehabilitation Hospital, Chengdu, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Shao
authors.affiliation: Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zhenguo
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Chinese PLA General Hospital, Beijing, China.
authors.forename: Zhenfu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Fujian Medical University Union Hospital, Fuzhou, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Chen
authors.affiliation: The First Hospital affiliated to Hebei Medical University, Shijiazhuang, China.
authors.forename: Mingwei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Peking Union Medical College Hospital, Beijing, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Wan
authors.affiliation: West China Hospital affiliated to Sichuan University, Chengdu, China.
authors.forename: Huifang
authors.initials: H
authors.lastname: Shang
authors.affiliation: Qilu Hospital affiliated to Shandong University, Jinan, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The First Hospital affiliated to Guangzhou Medical University, Guangzhou, China.
authors.forename: Pingyi
authors.initials: P
authors.lastname: Xu
authors.affiliation: Huashan Hospital affiliated to Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Tiantan Hospital affiliated to Capital Medical University, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Feng
authors.affiliation: The First Hospital affiliated to Anhui Medical University, Hefei, China.
authors.forename: Xianwen
authors.initials: X
authors.lastname: Chen
authors.affiliation: Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Xingyue
authors.initials: X
authors.lastname: Hu
authors.affiliation: The Affiliated Hospital, Qingdao University School of Medicine, Qingdao, China.
authors.forename: Anmu
authors.initials: A
authors.lastname: Xie
authors.affiliation: Department of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Xiao
keywords: Parkinson’s disease; Treatment guideline, optimal therapeutic options, China