Challenges in Parkinson's disease: restoration of the nigrostriatal dopamine system is not enough

  title={Challenges in Parkinson's disease: restoration of the nigrostriatal dopamine system is not enough},
  author={Anthony E. Lang and Jose A. Obeso},
  journal={The Lancet Neurology},
  • A. LangJ. Obeso
  • Published 1 May 2004
  • Psychology, Biology, Medicine
  • The Lancet Neurology

An update on the treatment of Parkinson's disease.

  • J. Jankovic
  • Medicine, Biology
    The Mount Sinai journal of medicine, New York
  • 2006
Future therapeutic strategies should focus not only on ameliorating the symptoms of PD, but also on neuroprotective or neurorescue therapies that can favorably modify the natural course of the disease and slow the progression of both motor and nonmotor manifestations of PD.

Treatment of Parkinson’s Disease: What’s in the Non-dopaminergic Pipeline?

Although the non-dopaminergic pipeline has been slow to yield new drugs, further development will likely result in improved treatments for PD symptoms that are induced by or resistant to dopamine replacement.

New pharmacologic horizons in the treatment of Parkinson disease

Novel strategies for pharmacological intervention with nondopaminergic treatments hold the promise of providing effective control or reversal of motor response complications.

Disease-modifying drugs and Parkinson's disease

Novel pharmacological targets for the treatment of Parkinson's disease

This review describes the important recent advances that underlie the development of novel dopaminergic and non-dopaminergic drugs for Parkinson's disease, and also for the motor complications that arise from the use of existing therapies.

Update on the management of motor complications in Parkinson's disease

This supplement reviews progress in the therapeutics of Parkinson’s disease from its early stages in which the goal is to slow or halt the progression of the disease and prevent L-dopa– related motor complications and concludes with novel medical and surgical therapies.

Impact of Newer Pharmacological Treatments on Quality of Life in Patients with Parkinson’s Disease

Clinical trials with an index of HR-QOL as an outcome measure are focused on, with particular emphasis on well designed, randomized, double-blind, placebo-controlled or active comparator-controlled methodology.

Status and future directions of clinical trials in Parkinson's disease.

Parkinson's disease and growth factors - are they the answer?

  • R. Barker
  • Biology, Psychology
    Parkinsonism & related disorders
  • 2009



Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson's disease. Pathophysiologic and clinical implications.

It is proposed that the motor deficits that are a constant and characteristic feature of idiopathic Parkinson's disease are for the most part a consequence of dopamine loss in the putamen, and that the dopamine-related caudate deficits are less marked or restricted to discrete functions only.

Etiology and pathogenesis of Parkinson's disease.

Recent advances in understanding the etiology and pathogenesis of PD are reviewed in the hope of developing a more effective therapy that will slow or halt the natural progression of PD.

Dopaminergic Transplants in Patients with Parkinson's Disease: Neuroanatomical Correlates of Clinical Recovery

The neuroanatomical correlates of dopamine brain grafting in humans is described and the pattern of changes seen in dopaminergic systems which are associated with clinical benefit are elucidated.

Plasticity of the nigropallidal pathway in Parkinson's disease

Enhanced function of the dopamine projection to the GPi serves, it is proposed, to maintain a more normal pattern of pallidal output to ventral thalamus and motor cortex in early PD, whereas loss of this adaptive pathway in advanced disease may be a pivotal step in the progression of the disease.

From Transplants to Gene Therapy for Parkinson's Disease

The symptoms that may improve following neuronal reconstruction are likely to be directly related to the somatotopic localization of the transplants; the duration of benefit should be long enough to be relevant in a chronic disease such as Parkinson's disease.

Transplantation of embryonic dopamine neurons for severe Parkinson's disease.

After improvement in the first year, dystonia and dyskinesias recurred in 15 percent of the patients who received transplants, even after reduction or discontinuation of the dose of levodopa.

Nigral and extranigral pathology in Parkinson's disease.

This article reviews data on the internal organization, neuronal types, and interconnections of limbic and motor components of the human brain, and the specific lesions which a few of them undergo

Pathogenesis and preclinical course of Parkinson's disease.

It is argued that IP should be regarded as a multisystem disorder, both at the level of individual neurons and at the whole brain level, and that a cascade of interacting and overlapping biochemical mechanisms determine the course of the disease.