Current Treatments and New, Tentative Therapies for Parkinson’s Disease

Abstract

Parkinson’s disease (PD) is a neurodegenerative pathology, the origin of which is associated with the death of neuronal cells involved in the production of dopamine. The prevalence of PD has increased exponentially. The aim of this review was to describe the novel treatments for PD that are currently under investigation and study and the possible therapeutic targets. The pathophysiology of this disease is based on the formation of alpha-synuclein folds that generate Lewy bodies, which are cytotoxic and reduce dopamine levels. Most pharmacological treatments for PD target alpha-synuclein to reduce the symptoms. These include treatments aimed at reducing the accumulation of alpha-synuclein (epigallocatechin), reducing its clearance via immunotherapy, inhibiting LRRK2, and upregulating cerebrosidase (ambroxol). Parkinson’s disease continues to be a pathology of unknown origin that generates a significant social cost for the patients who suffer from it. Although there is still no definitive cure for this disease at present, there are numerous treatments available aimed at reducing the symptomatology of PD in addition to other therapeutic alternatives that are still under investigation. However, the therapeutic approach to this pathology should include a combination of pharmacological and non-pharmacological strategies to maximise outcomes and improve symptomatological control in these patients. It is therefore necessary to delve deeper into the pathophysiology of the disease in order to improve these treatments and therefore the quality of life of the patients.

Current Drugs Strategies for Treatment of Rare Neurodegenerative Diseases

“…Current treatment is mainly based on restoring dopamine levels, with levodopa considered the main option. However, levodopa administration has limitations due to the occurrence of side effects, of which dyskinesia is a significant problem [43].…”

“…Catechol-O-methyltransferase (COMT) inhibitors such as entacapone and tolcapone have also been used. These tools improve dopamine levels and increase physical activity because they promote the absorption of levodopa in the intestine, where most of this enzyme is located [43].…”

“…Another class of drugs are dopamine agonists, such as ropinirole and pramipexole, which have been described as safe and effective as monotherapy and in combination with levodopa. In this group, rotigotine is available as a transdermal patch that provides continuous dosing, while apomorphine is available as an injection or subcutaneous infusion to rescue potency change in patients with systemic disease [43].…”

“…Advanced treatments are available for patients with motor disorders or dyskinesias that cause dysfunction and do not improve even with appropriate drug therapy. Deep brain stimulation (DBS), levodopa-carbidopa enteral suspension, and continuous subcutaneous infusion of apomorphine are the best-known alternatives [43].…”

“…Cognitive impairment, depression, sleep disorders, and functional impairments are non-motor problems in PD. The most common medications used to treat psychosis are acetylcholinesterase inhibitors such as donepezil, galantamine, and rivastigmine [43].…”