Parkinson disease: Not just a movement disorder

Pandya, Mayur; Kubu, Cynthia S.; Giroux, Monique

doi:10.3949/ccjm.75a.07005

Cited by 55 publications

(42 citation statements)

References 81 publications

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“…The core features are bradykinesia, resting tremor and rigidity. PD patients suffer from non-motor symptoms such as sleep disorders, neuropsychiatric issues and cognitive dysfunction [1,2]. The current treatment, based on a DA replacement strategy, consists of the oral administration of the DA precursor levodopa (L-DOPA).…”

Section: Introductionmentioning

confidence: 99%

Drug development in Parkinson's disease: From emerging molecules to innovative drug delivery systems

2013

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Current treatments for Parkinson's disease (PD) are aimed at addressing motor symptoms but there is no therapy focused on modifying the course of the disease.Successful treatment strategies have been so far limited and brain drug delivery remains a major challenge that restricts its treatment. This review provides an overview of the most promising emerging agents in the field of PD drug discovery, discussing improvements that have been made in brain drug delivery for PD. It will be shown that new approaches able to extend the length of the treatment, to release the drug in a continuous manner or to cross the blood brain barrier and target a specific region are still needed.Overall, the results reviewed here show that there is an urgent need to develop both symptomatic and disease-modifying treatments, giving priority to neuroprotective treatments. Promising perspectives are being provided in this field by rasagiline and by neurotrophic factors like glial cell line-derived neurotrophic factor. The identification of disease-relevant genes has also encouraged the search for disease-modifying therapies that function by identifying molecularly-targeted drugs. The advent of new molecular and cellular targets like α-synuclein, leucine-rich repeat serine/threonine protein kinase 2 or parkin, among others, will require innovative delivery therapies. In this regard, drug delivery systems (DDS) have shown great potential for improving the efficacy of conventional and new PD therapy and reducing its side effects. The new DDS discussed here, which include microparticles, nanoparticles and hydrogels among others, will probably open up possibilities that extend beyond symptomatic relief. However, further work needs to be done before DDS become a therapeutic option for PD patients.

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Section: Introductionmentioning

confidence: 99%

Drug development in Parkinson's disease: From emerging molecules to innovative drug delivery systems

2013

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“…1,5,6 Not only does this perceived poor quality of life stem from the chronic nature of PD, but also cognitive-behavioural comorbidities such as depression and apathy play a major role in the life quality of patients with PD. 1,5,6 A recent review has shown that moderate exercise was beneficial for mental health. 7 However, due to the motor disability resulting from PD, a vicious cycle of lesser exercise and a lower quality of life is created.…”

Section: After the Clinical Diagnosismentioning

confidence: 99%

“…Increasingly available evidence is showing that non-motor symptoms can be just as disabling to patients with PD as motor symptoms; and can be the result of the disease itself, its medications, or due to the on-off fluctuations in motor status due to the effects of the drugs wearing off. 1 Cognitive-behavioural comorbidities associated with PD necessitate a watchful eye to diagnose and treat. They can be difficult to recognise since they can mimic the physical features of PD; and can be difficult to treat due to adverse interactions of various PD medications.…”

Section: After the Clinical Diagnosismentioning

confidence: 99%

Mental health and Parkinson’s disease: from the cradle to the grave

Alamri

2015

Br J Gen Pract

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“…98 To complicate the issue further, levodopa therapy can induce hypotension through its diuretic and naturetic properties. Low-dose dopamine stimulates vascular smooth-muscle cell receptors to cause vasodilatation.…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Non-motor Symptoms in Parkinson’s Disease

Uç¹,

Tippin²,

Chou³

et al. 2011

US Neurology

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In addition to typical motor dysfunction (parkinsonism), diverse non-motor symptoms (NMS) are frequently observed in patients with Parkinsons disease (PD). Some NMS may antedate the diagnosis of PD. Examples of NMS include cognitive impairment, autonomic dysfunction, visual dysfunction, sleep abnormalities, and psychiatric disorders. NMS are associated with wide-ranging abnormalities in extranigral dopaminergic systems and non-dopaminergic (e.g. cholinergic, noradrenergic, serotoninergic) systems. The type and severity of NMS vary based on age, disease severity, and predominant motor symptoms. NMS can be disabling and reduce quality of life. Treatment of NMS can be challenging. Some NMS are helped by dopaminergic treatment, whereas others can be induced or exacerbated by treatments that help the motor dysfunction. Physicians should probe their PD patients about their NMS and address them for better care. Clinical trials should incorporate NMS as outcomes for more meaningful conclusions on the effect of treatments under investigation.

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Parkinson disease: Not just a movement disorder

Cited by 55 publications

References 81 publications

Drug development in Parkinson's disease: From emerging molecules to innovative drug delivery systems

Drug development in Parkinson's disease: From emerging molecules to innovative drug delivery systems

Mental health and Parkinson’s disease: from the cradle to the grave

Non-motor Symptoms in Parkinson’s Disease

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