Five major directions of progress in Parkinson s treatment

Mondo Health Updated on 2024-01-29

Parkinson's **British surgeon James Parkinson got his name. He is best known for his book An Essay on the Shaking Palsy, a clinical record of disabling conditions that cause movement disorders. Parkinson's disease was first described as a neurological syndrome in 1817. But as early as 1000 B.C., there are ancient Indian and Chinese sources that record symptoms similar to Parkinson's disease.

Jean-Martin Charcot, the French neurologist who gave the name to the disease, came to a conclusion that Parkinson's disease was different from other tremor disorders, especially polymorphization, because he found that not all patients with Parkinson's disease would experience tremor symptoms. Clinically, after the patient is diagnosed with Parkinson's disease, it is necessary to start the intervention of the first means. One of the common drugs is hyoscyamine, a plant-based sedative from Charcot. This is an anticholinergic drug that blocks the action of the neurotransmitter acetylcholine in the central nervous system (CNS) and is used to control tremors and reduce muscle stiffness. Then in the 20th century, with the advent of the breakthrough drug levodopa, dopamine-based ** also began to gain traction. As a temporary substitute for dopamine (dopamine levels drop in people with Parkinson's disease), levodopa is able to relieve movement disorders caused by the disease. But the drug's popularity is also of concern, in addition to known symptoms such as nausea and dizziness, long-term use of the drug may also trigger movement disorders. Over the years, as deep brain stimulation has become more and more popular in research, surgery has also become a viable option for Parkinson's disease. However, with Parkinson's disease affecting around 10 million people worldwide and the prevalence expected to double in the next 20 years, the current need for ** measures is unmet and researchers are working to find a solution. Among some of the new studies, here are five advances in Parkinson's disease research that could be transformative in research. #

Focused ultrasound: a new type of Parkinson's disease tremor

Focused ultrasound technology is becoming a hot technology, and some recent developments have attracted attention in the industry. Among them, researchers at the University of North Carolina at Chapel Hill School of Medicine (UNC) led a clinical trial that demonstrated that focused ultrasound technology can improve movement disorders in patients with Parkinson's disease. This ** is designed to address the involuntary movements that may occur in people with Parkinson's disease. These involuntary movements, including twitching, jerking, twisting, or twisting of the face, arms, legs, or torso, are often seen in people with Parkinson's disease who have been taking levodopa for a long time, an oral** medication that increases dopamine levels in the brain and reduces symptoms of the condition. In the trial, researchers at the University of North Carolina at Chapel Hill School of Medicine (UNC) evaluated 94 patients with Parkinson's disease and found that 75% of patients who received focused ultrasound** still had a positive response for about a year after completion. In addition to improving motor function and reducing involuntary movements, the procedure eliminates the risk of surgery because the procedure does not require incisions. Prior to this, surgeries commonly performed in patients with Parkinson's disease included thalamectomy and globus pallidustomy. These surgeries can cause damage to the thalamus or globus pallidus region of the patient, especially those who experience tremor, an involuntary movement that affects 80% of Parkinson's patients. Julie Pilitsis, a functional neurosurgeon at the Marcus Neuroscience Institute in Florida, said the surgeries, which make an incision in the thalamus that can cause damage to the brain, are becoming more attractive than methods such as focused ultrasound. "Focused ultrasound technology is not about implanting something in the brain, but just going into ...... magnetic resonance device (MRI).This means that the patient does not need to undergo a craniotomy. "For those older patients, I understand the reluctance to undergo surgery. ”#

Deep EEG stimulation combined with progress in Parkinson's disease is based

In 1997, deep EEG stimulation (DBS) began to be used for Parkinson's disease tremor. This method was approved in 2002 for advanced symptoms of Parkinson's disease and again in 2016 for earlier symptoms in patients whose motor symptoms are completely controlled by medication. Recently, DBS has received a lot of attention for its combination with the gene for Parkinson's disease** as stem cells**. Some studies have even considered combining genes** with DBS to replenish dopamine levels in the brain. According to Julie Pilitsis, stem cells and genes seem to be promising for Parkinson's disease in the future. "The technologies we're seeing so far are just electric currents or ultrasound. But over time, these tools will become more and more advanced. Julie Pilitsis said. DBS works like a pacemaker, stimulating specific parts of the brain through implanted electrodes. Julie Pilitsis explains the importance of stereotyped leads designed to expand the functionality of DBS by inducing stimuli more precisely. "It's really helpful because it's easier to program patients and reduce the number of people she says. However, the positioning of the defined leads is more challenging than that of traditional DBS leads. The current study of Julie Pilitsis will assess the extent of its effectiveness. Meanwhile, researchers at the University of California, San Francisco and The Ohio State University published a study in 2021 that aimed to address aromatic L-amino acid decarboxylase (AADC) deficiency through how genes ** work. AADC is a rare genetic disorder characterized by insufficient synthesis of dopamine and serotonin. The trial, which investigated the safety and efficacy of AADC-expressing viral vectors, showed increased polyamine metabolism and remission of ocular crisis movement (a condition that manifests as spasmodic movements of the eyeball, sometimes present in Parkinson's and Parkinson's disease**) in seven pediatric participants who received the **. Therefore, AADC-deficient gene vector delivery is thought to be effective in enhancing motor function, indicating its potential for Parkinson's disease. #

New study finds gut microbiota

Connection with Parkinson's

A study from the University of Alabama in the United States found a link between gut microbiota and the onset of Parkinson's disease. The study, led by Haydeh Payami, a professor in the university's Department of Neurology, examined a total of 257 species in the microbiota and concluded that 30% of the microbiota was associated with Parkinson's disease. "We found multiple mechanisms associated with Parkinson's disease, but we don't know how they occur in the gut and which microbiota plays a role. Payami said. The researchers also observed a series of changes in the study: the number of bacteria like Bifidobacterium, Actinomyces caries and Streptococcus mutans increased sixfold in the gut microbiota of Parkinson's patients, while Clostridium wexlerae and Rosaceus enterica decreased significantly. Although the relationship between neurodegenerative diseases and the intestinal system has been previously demonstrated, this study provides a broader perspective on how the gut microbiota affects Parkinson's disease. "This is exciting research because microbiome is an emerging but rapidly growing field that is still evolving despite its state-of-the-art resources, methods, and tools. Payami said that in the future there will be more tools to help ** the origin of Parkinson's disease and try to manipulate the microbiota to stop the disease from progressing. #

ABBVIE's drug candidate has encountered obstaclesBut could it be a best-selling drug?

ABBVIE's drug candidate ABBV-951, which consists of carbidopa and levodopa prodrugs, has caused a stir for its potential ability to fluctuate in motion in patients with advanced Parkinson's disease. The drug received a Full Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) to the New Drug Application (NDA) in March 2023. Although the FDA has not yet approved the drug candidate, ABBV-951 has been shown to be effective in clinical trials compared to other levodopa agents, with patients without disease-bothering movement disorders. The ABBV-951 drug candidate is designed to replace dopamine in the brain with continuous subcutaneous injection of carbidopa and levodopa for 24 hours, so the drug will be used in patients with high need. ABBVIE plans to resubmit the application soon, and the drug candidate has been praised by the industry for its flexibility in dosing. Analyst firm Clarivate's 2023 Drugs of Concern report noted that ABBV-951 "could be an alternative for patients who are not eligible for DBS surgery or do not wish to undergo surgery." #

Milestone, the Nadpark trial showed an improvement in NAD metabolism in Parkinson's patients

A recent study led by Professor Charalampos Tzoulis at Bergen University has shown that oral administration of nicotinamide riboside (NR) can enhance NAD metabolism in patients with Parson's disease. The experiment provides encouraging evidence for NR** Parkinson's disease. The study, called NADPARK, aims to determine whether the metabolism of NAD in the brains of people with Parkinson's disease can be enhanced by ingesting NR, a precursor to NAD. NAD is a metabolite responsible for maintaining cellular stability, which is often deficient in people with Parkinson's disease. "We believe that enhancing the brain's NAD metabolism can improve a variety of symptoms specific to Parkinson's disease, such as mitochondrial dysfunction, DNA damage, epigenetic abnormalities, and neuroinflammation. In addition, we speculate that NAD supplementation can also optimize neuronal metabolism and strengthen neurons, making them more resistant to age-related stress and neurodegenerative diseases. Tzoulis said. Tzoulis said the results were "very encouraging", noting that NR was "a potential neuroprotective factor in Parkinson's disease that warrants further study in larger trials". To further understand the extent to which NAD supplementation** modulates Parkinson's disease progression, Nopark is also conducting a Phase II study. Tzoulis said if the trial is successful, it would be a step towards developing a supervised drug to ** Parkinson's disease. "There is currently no way to slow or stop the progression of Parkinson's disease. As a result, patients face gradual disability and early death. If NAD supplementation is shown to have neuroprotective and disease-repairing effects on Parkinson's disease, it will cause a revolutionary change in the field and for the first time make it possible to improve the prognosis and even ** of Parkinson's disease. Tzoulis said.

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