Parkinson's disease diagnosis and treatment: Recent advancements
27 Feb 2018
Parkinson’s disease (PD) is a chronic and progressive neurodegenerative brain disorder that affects the individual’s movements. Parkinson has affected more than 10 million people globally. The incidence of PD increases markedly with age. The symptoms of the disease appear very late after the onset of the disease, with only 4% diagnosed before 50 years of age. Men are more prone to develop PD than women. There is a large population of senior citizens in India who may be susceptible to PD.
Mechanism and causes
The cause of PD is not exactly known, but, both genetic and environmental factors are believed to be involved. The accumulated misfolded proteins are likely to play the key role in PD neurodegeneration. Parkinson’s disease results in malfunction and death of the neurons- the vital nerve cells in the brain.
The primary motor signs of PD are:
- tremorof the hands, arms, legs, jaw and face
- bradykinesiaor slowness of movement
- rigidityor stiffness of the limbs and trunk
- postural instabilityor impaired balance and coordination
Treatment and medications
There is no cure for PD, however, the quality of life should be maintained by managing the symptoms with appropriate treatment. Life style changes and anaerobic exercise may help in treating the disease. Physiotherapy, for balancing and stretching, is also helpful. Speech-language therapy helps to resolve the speech problems. Deep brain stimulation was approved by the US FDA to treat PD in 2002.
Medications may help the patients of PD to manage the symptoms. These medications increase or substitute the specific signaling compound (neurotransmitter) dopamine in the brain. Carbidopa- levodopa combination remains the mainstay for managing this disease. Apart from this, some dopamine agonists (pramipexole, ropinirole), monoamine oxidase B inhibitor (elegiline and rasagiline), anticholinergics (benztropine or trihexyphenidyl) and amantadine are also widely used to treat the patients of PD.
Recent advancement to diagnose and treat Parkinson’s disease
Although, there is no cure available for PD, the ongoing research and findings provide hope for the development of new treatments for this disease.
Recent advancement in the diagnosis of PD
A recent study published in the Journal of the American Academy of Neurology, in Feb 2017, says that the diagnosis of PD may become easier with the help of a simple blood test. As PD is difficult to identify from atypical parkinsonism disorders (APDs), this test may help as its accuracy is similar to a spinal fluid test. This test could help both in the early stages as well as later by detecting the nerve protein neurofilament light chain protein, which is a part of nerve cells and can be found in the blood stream and spinal fluid when nerve cells die.
Recent advancements in the treatment of PD
According to the findings, published in Proceedings of the National Academy of Sciences, the naturally-occurring compound, called squalamine, can block the molecular process that is believed to underlie PD. This compound suppresses the toxic products of the disease and can be exploited in different ways to treat the patients of PD. The compound was found in the 1990s in dogfish sharks, considered as a steroid but found safer. The compound was earlier investigated as a potential antiinfective and anticancer treatment. Squalamine may be useful to target at least some of the symptoms of PD.
Researchers have utilized the stem cell technique, to turn a smaller part of skin from the patients with Parkinson’s into dopamine-producing brain cells – identical to those that are lost in Parkinson’s. Researchers have studied the patterns of gene activity and found the difference between Parkinson’s brain cells and normal brain cells (published in Human Molecular Genetics). By using the global database of drugs, the team identified the drug- clioquinol, which could normalize the gene activity of the Parkinson’s brain cells. Clioquinol is a drug used in creams for dermal infections.
Apart from this, as a part of the new drug delivery system (NDDS), to provide a faster onset and avoid gastro intestinal side-effects, the standard Parkinson’s medicine- levodopa has been developed recently in an inhaler form to deliver the drug through the lungs. This formulation of levodopa from Acorda Therapeutics (ACOR) has shown a statistically significant improvement in motor function in the patients experiencing OFF periods (re-emergence of Parkinson’s symptoms), as per the clinical data from a phase 3 trial.
Since, there is no cure for the Parkinson’s disease, physical, occupational and speech therapies have remained the mainstay of PD treatment along with levodopa. The recent advancements in its diagnosis and treatment may improve the lives of the patients in the foreseeable future. New research will have a positive impact upon society by treating PD.