Update in therapeutic strategies for Parkinson's disease
Por:
Kulisevsky, J, Oliveira, L, Fox, SH
Publicada:
1 ago 2018
Resumen:
Purpose of review
To review recent advances in therapeutics for motor and nonmotor symptoms of Parkinson's disease.
Recent findings
Neuroprotection remains a large area of investigation with preliminary safety data on alpha synuclein immunotherapy and glucagon-like peptide-1 agonists. Novel Monoamine Oxidase B and Caetchol-O-methyltransferase-inhibitors for motor fluctuations have shown benefit and are recently approved for clinical use. Long-acting amantadine has also been approved to reduce dyskinesia. Alternative delivery strategies (sublingual, inhaled) dopaminergics may prove useful for rapid reversal of Parkinson's disease motor symptoms. Advanced therapies (surgery and infusional therapies) continue to be useful in subgroups of patients for motor complications with improved safety and also benefit on some nonmotor symptoms, including neuropsychiatric issues. Specific therapeutics for cognition, swallowing, sleep, and mood disorders had moderate to limited benefits. Exercise-based therapy appears beneficial at all stages of Parkinson's disease.
Summary
The motor symptoms of Parkinson's disease can be reasonably treated and managed. However, therapies to slow or prevent disease progression remain a focus of research. Despite increased studies, treating nonmotor symptoms remains a challenge and an ongoing priority.
Filiaciones:
Kulisevsky, J:
Univ Autonoma Barcelona, Movement Disorders Unit, Dept Neurol, Sant Pau Hosp IIB St Pau, Barcelona, Spain
Univ Oberta Catalunya, CIBERNED, Barcelona, Spain
Oliveira, L:
Univ Hlth Network, Edmond J Safra Program Parkinsons Dis, Toronto Western Hosp, Toronto, ON, Canada
Univ Hlth Network, Morton & Gloria Shulman Movement Disorders Clin, Toronto Western Hosp, 399 Bathurst St, Toronto, ON M5T 2S8, Canada
Fox, SH:
Univ Hlth Network, Edmond J Safra Program Parkinsons Dis, Toronto Western Hosp, Toronto, ON, Canada
Univ Hlth Network, Morton & Gloria Shulman Movement Disorders Clin, Toronto Western Hosp, 399 Bathurst St, Toronto, ON M5T 2S8, Canada
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