Review: management of Parkinson's disease

Abstract

Parkinson’s disease (PD) is one of the most frequent neurological diseases. Despite the modern imaging and nuclear techniques which help to diagnose it in a very early stage and lead to a better discrimination of similar diseases, PD has remained a clinical diagnosis. The increasing number of available treatment options makes the disease management often complicated even when the presence of PD seems undoubted. In addition, nonmotor symptoms and side effects of some therapies constitute some pitfalls already in the preclinical state or at the beginnings of the disease, especially with the progressive effect on patients. Therefore, this review aimed to summarize study results and depict recommended medical treatments for the most common motor and nonmotor symptoms in PD. Additionally, emerging new therapeutic options such as continuous pump therapies, eg, with apomorphine or parenteral levodopa, or the implantation of electrodes for deep brain stimulation were also considered.

Comparison of the Efficacy of Different Drugs on Non-Motor Symptoms of Parkinson’s Disease: a Network Meta-Analysis

“…In 2011, a review suggested that piribedil, pramipexole, rotigotine, ropinirole, pramipexole extended release, pergolide, and cabergoline were efficacious as symptomatic monotherapies for motor symptoms of PD, and ropinirole prolonged release was likely efficacious [18]. There was also a study that summarized medical treatments for the most common motor and non-motor symptoms in PD [19]. In the current study, a network meta-analysis method is used for the quantitative comparison of different drug therapies for the treatment and management of PD to determine the optimal treatment and course of management for PD [20].…”

Multiple-Ascending-Dose Pharmacokinetics and Safety Evaluation of Baicalein Chewable Tablets in Healthy Chinese Volunteers

“…Several drugs (e.g. levodopa) have been developed for the treatment of PD, but there are none that can alter the underlying neurodegenerative process [2,3]. Recently, the concept of ''neuroprotective therapy'' has emerged as a potential treatment for PD [4,5].…”

Deep-Brain Stimulation for Parkinson's Disease

“…While STN and GPi are the main targets of DBS in PD patients as they alleviate a broader spectrum of motor symptoms, in contrast to Vim which helps primarily with tremors [1], the benefit of their stimulation on axial and nonmotor symptoms is limited [2]. D. Anderson et al describe the role of emerging alternative DBS targets such as the pedunculopontine nucleus, caudal zona incerta, substantia nigra pars reticulata, and the motor cortex for control of axial symptoms such as freezing, postural instability, gait, speech, and swallowing and nonmotor symptoms such as memory impairment, attention decline, and sleep disturbances in PD patients.…”