Medical, surgical, and physical treatments for Parkinson's disease

Foltynie, Tom; Bruno, Veronica; Fox, Susan; Kühn, Andrea A; Lindop, Fiona; Lees, Andrew J

doi:10.1016/s0140-6736(23)01429-0

Cited by 39 publications

(5 citation statements)

References 200 publications

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“…Overall, our review highlights the potential of BoNT as a component of a multidisciplinary approach to managing APAs in PD while also emphasizing the need for further research to refine treatment strategies and improve patient multidisciplinary care [2,19,103].…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin for Axial Postural Abnormalities in Parkinson’s Disease: A Systematic Review

Gandolfi,

Artusi,

Imbalzano

et al. 2024

Toxins

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Axial postural abnormalities (APAs), characterized by their frequency, disabling nature, and resistance to pharmacological treatments, significantly impact Parkinson’s disease and atypical Parkinsonism patients. Despite advancements in diagnosing, assessing, and understanding their pathophysiology, managing these complications remains a significant challenge. Often underestimated by healthcare professionals, these disturbances can exacerbate disability. This systematic review assesses botulinum toxin treatments’ effectiveness, alone and with rehabilitation, in addressing APAs in Parkinson’s disease, utilizing MEDLINE (PubMed), Web of Science, and SCOPUS databases for source material. Of the 1087 records retrieved, 16 met the selection criteria. Most research has focused on botulinum toxin (BoNT) as the primary treatment for camptocormia and Pisa syndrome, utilizing mostly observational methods. Despite dose and injection site variations, a common strategy was using electromyography-guided injections, occasionally enhanced with ultrasound. Patients with Pisa syndrome notably saw consistent improvements in APAs and pain. However, studies on the combined effects of botulinum toxin and rehabilitation are limited, and antecollis is significantly under-researched. These findings recommend precise BoNT injections into hyperactive muscles in well-selected patients by skilled clinicians, avoiding compensatory muscles, and underscore the necessity of early rehabilitation. Rehabilitation is crucial in a multidisciplinary approach to managing APAs, highlighting the importance of a multidisciplinary team of experts.

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Section: Discussionmentioning

confidence: 99%

Botulinum Toxin for Axial Postural Abnormalities in Parkinson’s Disease: A Systematic Review

Gandolfi,

Artusi,

Imbalzano

et al. 2024

Toxins

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“…The pathogenesis of PD also includes oxidative stress, high levels of ROS, mitochondrial dysfunction and excessive activation of inflammatory processes [ 53 ]. As with other neurodegenerative disorders, there is also no effective treatment of PD, and only partial control of the symptoms and the course of the disease is currently available [ 54 ].…”

Section: Overview Of the Use Of Flavonoids In Neurodegenerative Disor...mentioning

confidence: 99%

Effectiveness of Flavonoid-Rich Diet in Alleviating Symptoms of Neurodegenerative Diseases

Szulc,

Wiśniewska,

Żabińska

et al. 2024

Foods

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Over the past decades, there has been a significant increase in the burden of neurological diseases, including neurodegenerative disorders, on a global scale. This is linked to a widespread demographic trend in which developed societies are aging, leading to an increased proportion of elderly individuals and, concurrently, an increase in the number of those afflicted, posing one of the main public health challenges for the coming decades. The complex pathomechanisms of neurodegenerative diseases and resulting varied symptoms, which differ depending on the disease, environment, and lifestyle of the patients, make searching for therapies for this group of disorders a formidable challenge. Currently, most neurodegenerative diseases are considered incurable. An important aspect in the fight against and prevention of neurodegenerative diseases may be broadly understood lifestyle choices, and more specifically, what we will focus on in this review, a diet. One proposal that may help in the fight against the spread of neurodegenerative diseases is a diet rich in flavonoids. Flavonoids are compounds widely found in products considered healthy, such as fruits, vegetables, and herbs. Many studies indicated not only the neuroprotective effects of these compounds but also their ability to reverse changes occurring during the progression of diseases such as Alzheimer’s, Parkinson’s and amyotrophic lateral sclerosis. Here, we present the main groups of flavonoids, discussing their characteristics and mechanisms of action. The most widely described mechanisms point to neuroprotective functions due to strong antioxidant and anti-inflammatory effects, accompanied with their ability to penetrate the blood-brain barrier, as well as the ability to inhibit the formation of protein aggregates. The latter feature, together with promoting removal of the aggregates is especially important in neurodegenerative diseases. We discuss a therapeutic potential of selected flavonoids in the fight against neurodegenerative diseases, based on in vitro studies, and their impact when included in the diet of animals (laboratory research) and humans (population studies). Thus, this review summarizes flavonoids’ actions and impacts on neurodegenerative diseases. Therapeutic use of these compounds in the future is potentially possible but depends on overcoming key challenges such as low bioavailability, determining the therapeutic dose, and defining what a flavonoid-rich diet is and determining its potential negative effects. This review also suggests further research directions to address these challenges.

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“…Because PD is thought to have a complex etiology including a confluence of environmental and genetic elements, developing efficient therapies is made more difficult [ 4 ]. While dopamine replacement therapy is essential for treating Parkinson's disease, the holistic treatment requires a comprehensive approach and a multidisciplinary team for effective long-term management [ 5 ]. Therefore, early identification and optimal management are critical, as they can significantly improve patients' symptoms and social functions while reducing the burden on families and society.…”

Section: Introductionmentioning

confidence: 99%

Hearing loss is not associated with risk of Parkinson's disease: A Mendelian randomization study

Ning,

Mu,

Guo

et al. 2024

Heliyon

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Medical, surgical, and physical treatments for Parkinson's disease

Cited by 39 publications

References 200 publications

Botulinum Toxin for Axial Postural Abnormalities in Parkinson’s Disease: A Systematic Review

Botulinum Toxin for Axial Postural Abnormalities in Parkinson’s Disease: A Systematic Review

Effectiveness of Flavonoid-Rich Diet in Alleviating Symptoms of Neurodegenerative Diseases

Hearing loss is not associated with risk of Parkinson's disease: A Mendelian randomization study

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