Secondary Logo

Institutional members access full text with Ovid®

Update in therapeutic strategies for Parkinson's disease

Kulisevsky, Jaimea; Oliveira, Laisb; Fox, Susan H.b

doi: 10.1097/WCO.0000000000000579
MOVEMENT DISORDERS: Edited by Marie Vidailhet
Buy

Purpose of review To review recent advances in therapeutics for motor and nonmotor symptoms of Parkinson's disease.

Recent findings Neuroprotection remains a large area of investigation with preliminary safety data on alpha synuclein immunotherapy and glucagon-like peptide-1 agonists. Novel Monoamine Oxidase B and Caetchol-O-methyltransferase-inhibitors for motor fluctuations have shown benefit and are recently approved for clinical use. Long-acting amantadine has also been approved to reduce dyskinesia. Alternative delivery strategies (sublingual, inhaled) dopaminergics may prove useful for rapid reversal of Parkinson's disease motor symptoms. Advanced therapies (surgery and infusional therapies) continue to be useful in subgroups of patients for motor complications with improved safety and also benefit on some nonmotor symptoms, including neuropsychiatric issues. Specific therapeutics for cognition, swallowing, sleep, and mood disorders had moderate to limited benefits. Exercise-based therapy appears beneficial at all stages of Parkinson's disease.

Summary The motor symptoms of Parkinson's disease can be reasonably treated and managed. However, therapies to slow or prevent disease progression remain a focus of research. Despite increased studies, treating nonmotor symptoms remains a challenge and an ongoing priority.

aMovement Disorders Unit, Neurology Department, Sant Pau Hospital (IIB Sant Pau), Universitat Autònoma de Barcelona, CIBERNED, Universitat Oberta de Catalunya, Barcelona, Spain

bEdmond J. Safra Program in Parkinson's Disease and The Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

Correspondence to Susan H. Fox, MRCP (UK), PhD, Movement Disorder Clinic, Edmund J Safra Progam in Parkinson Disease, and The Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, 399, Bathurst St, Toronto, ON M5T2S8, Canada. Tel: +1 416 6 03 6422; e-mail: sfox@uhnresearch.ca

Copyright © 2018 Wolters Kluwer Health, Inc. All rights resereved.