The scientific and clinical basis for the treatment of Parkinson disease (2009)

  title={The scientific and clinical basis for the treatment of Parkinson disease (2009)},
  author={C. Warren Olanow and Matthew B. Stern and Kapil Sethi},
  pages={S1 - S136}
Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1–2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive… 

New pharmacological options for treating advanced Parkinson's disease.

Parkinson's disease: Diagnosis and appreciation of comorbidities.

Therapeutic prospects for Parkinson disease

Major therapeutic unmet needs include a dopaminergic therapy that is not associated with serious side effects, a therapy that addresses the non‐motor and non‐dopaminergic features of the disease, and a disease‐modifying therapy that slows or stops disease progression.

Levodopa in the treatment of Parkinson’s disease: an old drug still going strong

The issue of LD delivery as a critical factor for the drug’s propensity to induce motor complications is addressed and the available evidence regarding the use of LD to treat PD is summarized.

Parkinson's disease: health-related quality of life, economic cost, and implications of early treatment.

  • Jack J. Chen
  • Medicine, Psychology
    The American journal of managed care
  • 2010
To date, numerous compounds have been evaluated in clinical trials, but none has demonstrated irrefutable and enduring disease-modifying qualities, although the best available clinical evidence appears most promising for rasagiline.

Early diagnosis of Parkinson's disease: recommendations from diagnostic clinical guidelines.

Recommendations for the clinical diagnosis of Parkinson's disease based on clinical features and response to antiparkinsonian medication can be achieved with a fairly high level of accuracy, particularly when made by a physician specializing in movement disorders.

Parkinson’s disease: will therapy move beyond dopaminergic medication?

Treatment of the nondopaminergic and nonmotor symptoms of Parkinson’s disease necessitates the targeting of transmitter systems beyond dopamine, among these 5-HT agonists, glutamate antagonists, adenosine A2 antagonists and the α-adrenergic-receptor antagonists are detailed.



Timing of treatment initiation in Parkinson's disease: A need for reappraisal?

Clinical and imaging data both indicate that the early period after diagnosis is critical in terms of the rate of progression, implying that this is also a time of opportunity for interventions seeking to modify the course of the disease.

Genetic mouse models of parkinsonism: Strengths and limitations

The recent discovery of specific genes causing familial forms of PD has contributed to the development of novel genetic mouse models of PD, and a review discusses the validity, benefits, and limitations of these new models.

Neuroprotection in Parkinson disease: mysteries, myths, and misconceptions.

Clinical trials aimed at detecting neuroprotection in Parkinson disease are reviewed and the controversies surrounding the interpretation of these studies are addressed.

Basal ganglia, Parkinson's disease and levedopa therapy

Levodopa in the treatment of Parkinson's disease: Current controversies

  • C. OlanowY. Agid F. Stocchi
  • Biology, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 2004
Treatment strategies that provide more continuous stimulation of dopamine receptors provide reduced motor complications in MPTP monkeys and PD patients and studies raise the possibility that more continuous and physiological delivery of levodopa might reduce the risk of motor complications.

Stem cell treatment for Parkinson's disease: an update for 2005

Stem cells have been shown to be capable of differentiating into dopamine neurons that provide benefits following transplantation in animal models of Parkinson's disease, however, cell survival and behavioral responses are limited.

An algorithm (decision tree) for the management of Parkinson’s disease (2001):

Physicians who treat PD patients must now assimilate a considerable body of data to optimally manage patients with this complex disorder and to a variety of new treatment strategies for the management of PD.

Levodopa and the progression of Parkinson's disease.

The clinical data suggest that levodopa either slows the progression of Parkinson's disease or has a prolonged effect on the symptoms of the disease, and the neuroimaging data suggest either thatlevodopa accelerates the loss of nigrostriatal dopamine nerve terminals or that its pharmacologic effects modify the dopamine transporter.

Etiology and Pathogenesis of Parkinson’s Disease

Genetic factors clearly contribute to the pathogenesis of Parkinson’s disease, and many studies have shed light on their implication in, not only monogenic, but also sporadic forms of PD.

The causes of parkinson's disease are being unraveled and rational neuroprotective therapy is close to reality

It is suggested that it may be more profitable to test a large number of agents in a small number of selected patients in search of a more robust neuroprotective effect, to reduce the risk of missing a powerful neuroProtective treatment with a treatment that might not otherwise have been studied because of a lack of time, money, or patients.