New directions in Parkinson’s research and treatment

Abstract

L-DOPA remains the mainstay of therapy for Parkinson’s disease (PD). However, the side-effects associated with its chronic use have fuelled the search for novel strategies as an alternative to simply supplementing dopamine deficiency. In reviewing the advances made over the last five years, focus has been given to dopamine agonists, as well as to new MAO inhibitors that appear more effective than the currently used compound, selegiline. A number of new molecules acting at sites of the neuronal circuit distal from lesioned dopaminergic neurones have also been considered, including NMDA antagonists, adenosine antagonists and anticholinergic agents, this latter group representing the pioneering approach to PD treatment. In addition, new concepts of ‘neuroprotection’ have led to the exploitation of various agents, especially anti-oxidants, directed toward slowing or halting disease progression. An entirely new perspective has been provided by methods that apply the techniques of molecular biology to PD therapy and allow modified dopaminergic neurones capable of synthesising specific neurotrophic factors to be obtained by transfection. Parkinson’s research has now progressed extensively, and further understanding of the aetiology of neuronal degeneration will disclose the key to the development of an effective therapy.

• anticholinergics
• anti-oxidants
• dopamine agonists
• L-DOPA therapy
• MAO inhibitors
• neurodegeneration
• neuroprotective agents
• NMDA antagonists
• oxidative stress
• Parkinson’s disease treatment