Therapeutic prospects for Parkinson disease

Abstract

Dopaminergic therapies such as levodopa have provided benefit for millions of patients with Parkinson's disease (PD) and revolutionized the treatment of this disorder. However patients continue to experience disability despite the best of modern treatment. Dopaminergic and surgical therapies are associated with potentially serious side effects. Non-motor and non-dopaminergic features such as freezing, falling, and dementia are not adequately controlled with available medications and represent the major source of disability for advanced patients. And, the disease continues to relentlessly progress. Major therapeutic unmet needs include a dopaminergic therapy that is not associated with serious side effects, a therapy that addresses the non-motor and non-dopaminergic features of the disease, and a disease-modifying therapy that slows or stops disease progression. This review will consider current attempts to address these issues and the obstacles that must be overcome in order to develop more effective therapies for PD.

Glucocerebrosidase Mutations in Parkinson Disease

“…The discovery of the link between GBA mutations and PD has opened up a novel area for therapeutic investigation, with the possibility of targeting GCase as an important contributor to autophagy dysfunction and alpha synuclein accumulation in the disease [83]. The similarity in clinical presentation, pathology and disease progression between GBA mutation carriers and non-carriers, suggests that neuroprotective treatments developed on the basis of GBA-PD research could be translated to idiopathic PD.…”

Levodopa/Carbidopa Intestinal Gel for Treatment of Advanced Parkinson’s Disease: An Update on the Effects of Cognitive Functions

“…Management of neuropsychiatric and cognitive deficits is an unmet need of the advanced stages of PD [70], with severe impact on daily functioning. The negative effects of DRT on neuropsychiatric and cognitive symptoms in advanced PD stages frequently prevent an optimal therapeutic management.…”

Mapping Nursing language terms of Parkinson's disease

“…Parkinson's disease (PD) patient nursing care with those who are assisted in a neurological rehabilitation program can be considered complex work, both from signs and symptoms of the disease itself, as well as the mixed ideas inherent to the principles of rehabilitation (1)(2) . This disorder, which affects about five million people worldwide, was seen for a long time as a mobility disorder, which had the main features of classic motor symptoms resulting from dopamine depletion in specific brain regions.…”

“…This disorder, which affects about five million people worldwide, was seen for a long time as a mobility disorder, which had the main features of classic motor symptoms resulting from dopamine depletion in specific brain regions. However, recent studies have shown that the clinical manifestations of PD are not only related to dopaminergic dysfunction occurring in the substantia nigra, they go beyond that, as the scattered impairment of the central nervous system favors the onset of symptoms considered motor and non-motor, and are characterized by bladder, bowel, sexual and mental dysfunction (1)(2)(3) . These findings redirect the debate on PD pathophysiology and encourage discussion on the impact of these symptoms in the evolution of this disease, considered as progressive and multisystem (1,3) .…”

“…However, recent studies have shown that the clinical manifestations of PD are not only related to dopaminergic dysfunction occurring in the substantia nigra, they go beyond that, as the scattered impairment of the central nervous system favors the onset of symptoms considered motor and non-motor, and are characterized by bladder, bowel, sexual and mental dysfunction (1)(2)(3) . These findings redirect the debate on PD pathophysiology and encourage discussion on the impact of these symptoms in the evolution of this disease, considered as progressive and multisystem (1,3) . In this sense, the work of nurses in the context of rehabilitation of PD patients permeates aspects related to the limitations imposed by the disease.…”