Treatment Options for Motor and Non-Motor Symptoms of Parkinson’s Disease

Abstract

Parkinson’s disease (PD) usually presents in older adults and typically has both motor and non-motor dysfunctions. PD is a progressive neurodegenerative disorder resulting from dopaminergic neuronal cell loss in the mid-brain substantia nigra pars compacta region. Outlined here is an integrative medicine and health strategy that highlights five treatment options for people with Parkinson’s (PwP): rehabilitate, therapy, restorative, maintenance, and surgery. Rehabilitating begins following the diagnosis and throughout any additional treatment processes, especially vis-à-vis consulting with physical, occupational, and/or speech pathology therapist(s). Therapy uses daily administration of either the dopamine precursor levodopa (with carbidopa) or a dopamine agonist, compounds that preserve residual dopamine, and other specific motor/non-motor-related compounds. Restorative uses strenuous aerobic exercise programs that can be neuroprotective. Maintenance uses complementary and alternative medicine substances that potentially support and protect the brain microenvironment. Finally, surgery, including deep brain stimulation, is pursued when PwP fail to respond positively to other treatment options. There is currently no cure for PD. In conclusion, the best strategy for treating PD is to hope to slow disorder progression and strive to achieve stability with neuroprotection. The ultimate goal of any management program is to improve the quality-of-life for a person with Parkinson’s disease.

Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression

“…To our knowledge, the present study, with 6 years, has the longest exercise maintenance program and detraining followups in PwPD compared with the follow-up durations of 17 days, 1, 2, and 6 months (15, 50-52) or 2 years (23,31,32). While the complementary and alternative medical approaches are considered for minimizing the symptom-progression (12), exercise therapy is emerging as an efficacious symptom management option in PwPD (8,53,54). The uniform pattern produced by the M-program across the outcomes was that it further increased the exercise-induced gains for up to 3 months when these gains plateaued (Figures 2, 3).…”

“…The drugs are still the primary symptom-moderators in people with PD (PwPD), as the lesion surgeries and deep brain stimulation cannot halt the progression of the underlying neurodegenerative processes (4). Physical exercise has been also used as an adjuvant to the drugs to reduce the motor and nonmotor PD-symptoms and improve quality of life (2,3,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The potency of exercise is revealed by the 21 year delay in the clinical manifestation of PD in the physically active individuals (20).…”

“…The no exercise and no maintenance control (C, n = 26) group continued habitual living. In each patient, 11 outcomes were measured before and after the 3-week initial exercise program and then, at 3,6,12,18,24,36,48,60, and 72 months.…”

Golf as a Physical Activity to Potentially Reduce the Risk of Falls in Older Adults with Parkinson’s Disease

“…Parkinson’s disease (PD) is a chronic neurodegenerative disorder that results from the progressive death of dopaminergic neurons located in the substantia nigra and resultant degeneration of dopaminergic pathways in the basal ganglia [ 1 , 2 , 3 ]. The loss of dopamine alters both inhibitory and excitatory pathways, resulting in the PD cardinal motor signs: bradykinesia (slowness of movement), tremor (trembling in hands, arms, legs, jaw, and face), impaired balance and posture, and muscle rigidity (stiffness of the limbs and trunk) [ 4 , 5 , 6 , 7 ]. Other non-motor PD symptoms may include depression and other psychiatric manifestations; difficulty swallowing and speaking; urinary problems or constipation; sleep disruption; and a myriad of other symptoms not overtly seen or displayed [ 6 , 7 , 8 , 9 , 10 , 11 ].…”

Glitazone Treatment Rescues Phenotypic Deficits in a Fly Model of Gaucher/Parkinson’s Disease

“…A study surveying ongoing clinical trials for therapeutics targeting PD showed that 39% are focused on long-term disease-modifying therapies, with the majority of trials (61%), focused on symptomatic relief [ 47 ]. Currently, the main mode of treatment is the administration of the DA precursor, levodopa [ 48 ]. Current treatments for patients with GD include enzyme replacement therapy, designed to supply the GBA enzyme in cells that are lacking the enzyme and substrate reduction therapy (SRT), which reduces the excess glucosylceramide substrate.…”