Sunday, April 2, 2017
Recent advances in Parkinson's disease therapy
Abstract (as presented by the author of the scientific work):
"This article summarizes (1) the recent achievements to further improve symptomatic therapy of motor Parkinson's disease (PD) symptoms, (2) the still-few attempts to systematically search for symptomatic therapy of non-motor symptoms in PD, and (3) the advances in the development and clinical testing of compounds which promise to offer disease modification in already-manifest PD. However, prevention (that is, slowing or stopping PD in a prodromal stage) is still a dream and one reason for this is that we have no consensus on primary endpoints for clinical trials which reflect the progression in prodromal stages of PD, such as in rapid eye movement sleep behavior disorder (RBD) -a methodological challenge to be met in the future."
Covered topics (the letter size corresponds to the frequency of mentioning in the text):
Conclusions (as presented by the author of the scientific work):
"Neurologists have to accept that the majority of patients with PD, even at the very early stage of neurological diagnosis, actually present a late-stage phenotype of an alpha-synucleinopathy. Thus, PD has started at least 20 years before it manifests in the clinic with its motor symptoms. Neurologists will likely have to shift their clinical and diagnostic focus away from the dopaminergic system to symptoms related to different parts of the nervous system, such as the enteric system62, the brainstem with its autonomic control areas, the locus coeruleus57, or even the skin. If the dream of a disease-modifying therapy is to come true, neuroscience, drug development, and physician scientists face at least two challenges. First, drug development will target the aggregation and propagation of alpha-synuclein and of related mechanisms as well as mitochondrial dysfunction; second, a major effort has to be made to enhance the diagnostic methodology in order to identify a primary endpoint for clinical neuroprotective trials, not only in early motor PD but also in the prodromal stages of PD82–84. It has never been so exciting as today to work in the field of PD, and we should share this belief with the patients we diagnose, treat, and care for."
Full-text access of the referenced scientific work:
Oertel WH. Recent advances in treating Parkinson's disease. F1000Res. 2017 Mar
13;6:260. doi: 10.12688/f1000research.10100.1. eCollection 2017. Review. PubMed
PMID: 28357055; PubMed Central PMCID: PMC5357034.
Prof. Atanas G. Atanasov (Dr. habil., PhD)