title: [Nonpharmacological treatment procedures for Parkinson's disease].
abstract: Nonpharmacological treatment strategies in Parkinson' disease include heterogeneous treatment modalities, such as physiotherapy, occupational therapy, speech therapy, cognitive training and deep brain stimulation as well as noninvasive brain stimulation strategies. Even in the early stages of Parkinson's disease nonpharmacological interventions, such as active exercise therapy and speech therapy can be indicated taking the individual symptoms of a patient into account. Mild cognitive deficits are frequently detected in the course of the disease and progression of these disorders to dementia in the advanced stages of the disease is not uncommon. The starting point for a cognitive training, training strategy and training frequency is unknown and currently under investigation. Deep brain stimulation is an established treatment modality, which should be considered when motor fluctuations cannot be adequately controlled by pharmacological treatment. This therapeutic option depends on patient-specific needs and has to be managed by a multiprofessional team. Non-invasive neurostimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation are experimental tools and cannot currently be recommended for general use.
authors.affiliation: Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian Albrechts Universität Kiel, Rosalind Franklin Straße 10, 24105, Kiel, Deutschland. k.witt@neurologie.uni-kiel.de.
authors.forename: K
authors.initials: K
authors.lastname: Witt
authors.affiliation: Medizinische Psychologie | Neuropsychologie und Gender Studies & Center für Neuropsychologische Diagnostik und Intervention (CeNDI), Zentrum für Neurologie und Psychiatrie, Uniklinik Köln, Köln, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Kalbe
authors.affiliation: Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian Albrechts Universität Kiel, Rosalind Franklin Straße 10, 24105, Kiel, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Erasmi
authors.affiliation: Neurologisches Fachkrankenhaus für Bewegungsstörungen/Parkinson, Beelitz-Heilstätten, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Ebersbach
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D046690:Deep Brain Stimulation / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D009788:Occupational Therapy / Q000379:methods*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000628:therapy*; D026741:Physical Therapy Modalities; D013070:Speech Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents
keywords: Deep brain stimulation; Mild cognitive deficits; Non-invasive neurostimulation; Physiotherapy; Speech therapy