Leveraging Large Language Models for Personalized Parkinson's Disease Treatment.

Abstract

Parkinson's Disease (PD) treatment is challenging due to symptom heterogeneity and the lack of a definitive cure. Lifelong medication requires personalized treatment plans developed by physicians, but such approaches are constrained by high costs and limited physician capacity. Although deep learning (DL) methods have been explored, they lack interpretability and are restricted to numerical data inputs. In this study, we propose a novel framework that leverages large language models (LLMs) to design personalized PD treatment strategies, integrating both patient information in natural language form and external textual knowledge sources (e.g., medical guidelines). To enhance effectiveness, we use Monte Carlo Tree Search (MCTS) to refine strategies and establish a robust medication recommendation dataset. To enhance reliability and interpretability, we incorporate Retrieval-Augmented Generation (RAG) and Chain-of-Thought (CoT) reasoning within the LLM system, ensuring that each proposed strategy is accompanied by step-by-step explanations and references to similar historical cases. Experimental evaluations using the Parkinson's Progression Marking Initiative (PPMI) dataset show that our method surpasses physician-prescribed treatments, achieving an average reduction of over 1.4 points in the revised unified Parkinson's disease rating scale part III (MDS-UPDRS-III) scores. Our method also outperforms the RL-method by 1.01 points on average. Furthermore, over 43% of patients achieve more than 2 point-reduction of MDS-UPDRS-III scores. A detailed case study highlights the flexibility of LLMs in dynamically adjusting medication plans for patients at different disease stages, highlighting its potential to advance personalized PD management in real-world settings.