What New Treatments Are Being Developed
Thanks to the progress we’ve already made, new treatments are being tested in clinical trials that have the potential to slow, stop or even reverse Parkinson’s.
- stem cell therapies, which aim to use healthy, living cells to replace or repair the damage in the brains of people with Parkinson’s;
- gene therapies, which use the power of genetics to reprogramme cells and change their behaviour to help them stay healthy and work better for longer
- growth factors , which are naturally occurring molecules that support the growth, development and survival of brain cells.
And we’re developing treatments that aim to improve life with the condition, including new drugs that can reduce dyskinesia.
Advances In Deep Brain Stimulation
Deep brain stimulation is another established treatment for PD that is useful in treating dopamine-dependent motor symptoms when levodopa-induced side effects become particularly problematic. DBS involves the surgical implantation of electrodes that stimulate subcortical structures including the subthalamic nucleus and globus pallidus internus. DBS offers significant improvements in motor symptoms and fluctuations in comparison to best medical therapy in some advanced PD patients, but dopamine-resistant symptoms other than tremor respond poorly. It has also been suggested in an open-label trial that DBS is beneficial in early PD patients, with improved tremor scores and reduced development ofde novo tremor. In addition to surgical complications, DBS strategies may cause cognitive and neuropsychiatric adverse effects as well as speech dysfunction. Novel DBS approaches, including adaptive DBS, targeting different regions, and refined intra-operative imaging techniques promise to offer improved clinical applicability and reduce the impact of adverse effects.
Alpha Synuclein Receives Renewed Attention
The past year has witnessed a renewed interest in alpha synuclein, said Dr. Davis. In Parkinsons disease, the protein forms abnormal polymers and accumulates in Lewy bodies. Removing abnormal or dysfunctional alpha synuclein might reduce symptoms or modify the disease course. One way to effect this removal is to increase autophagy, the bodys mechanism for clearing dysfunctional proteins.
Nilotinib, a tyrosine kinase inhibitor approved for the treatment of Philadelphia-positive chronic myelocytic leukemia, increases autophagy clearance of alpha synuclein in rodent models. In 2016, researchers randomized 12 patients with either Parkinsons disease dementia or dementia with Lewy bodies to 150 mg/day or 300 mg/day of nilotinib for 24 weeks. The drug appeared to be safe and well tolerated, and the results suggested possible motor and cognitive benefits of treatment. CSF levels of homovanillic acid, the end metabolite of dopamine, were significantly increased at week 24, compared with baseline, suggesting an increase in dopamine production. The trial was open label.
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Parkinsons Treatment On The Horizon
Immunotherapy:; Researchers at the Columbia University Medical Center and the La Jolla Institute for Allergy and Immunology have found evidence that autoimmunityin which the immune system attacks the bodys own tissuesplays a role in Parkinsons disease. The findings raise the possibility that the death of neurons in Parkinsons could be prevented by therapies that dampen the immune response.
Our findings raise the possibility that an immunotherapy approach could be used to increase the immune systems tolerance for alpha-synuclein, which could help to ameliorate or prevent worsening symptoms in Parkinsons disease patients, says study co-leader Alessandro Sette, Dr. Biol. Sci., professor in the Center for Infectious Disease at La Jolla Institute for Allergy and Immunology in La Jolla, Calif. The study was published in;Nature.
The idea that a malfunctioning immune system contributes to Parkinsons dates back almost 100 years, said study co-leader David Sulzer, PhD, professor of neurobiology at CUMC. But until now, no one has been able to connect the dots. Our findings show that two fragments of alpha-synuclein, a protein that accumulates in the brain cells of people with Parkinsons, can activate the T cells involved in autoimmune attacks.
This is the strongest evidence we have so far that a drug could do more than provide symptom relief for Parkinsons disease, says the studys senior author, Professor Tom Foltynie .
Medicines For Parkinsons Disease
Medicines prescribed for Parkinsons include:
- Drugs that increase the level of dopamine in the brain
- Drugs that affect other brain chemicals in the body
- Drugs that help control nonmotor symptoms
The main therapy for Parkinsons is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brains dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapysuch as nausea, vomiting, low blood pressure, and restlessnessand reduces the amount of levodopa needed to improve symptoms.
People with Parkinsons should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.
Other medicines used to treat Parkinsons symptoms include:
- Dopamine agonists to mimic the role of dopamine in the brain
- MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
- COMT inhibitors to help break down dopamine
- Amantadine, an old antiviral drug, to reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
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Scientists Have Made A Breakthrough In The Development Of A Nasal Spray For Parkinsons Disease Treatment
Researchers from the University of York have developed a new gel that can adhere to tissue inside the nose alongside the drug levodopa, helping deliver Parkinsons disease treatment directly to the brain.
Parkinsons disease is a condition in which parts of the brain become progressively damaged over many years. This leads to a reduction in dopamine in the brain, which plays a vital role in regulating the movement of the body. The main symptoms include involuntary shaking, slow movement, and stiff and inflexible muscles.
Whats New In Parkinsons: September 2020
Fall has arrived with cooler temperatures and a wealth of new discoveries about Parkinsons. Weve rounded up some of the most important articles, podcasts, research, and living well stories that hit the news this month for you to check out. Let us know if we missed anything important. Happy reading!
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What Are The Side
Some of the patients who were treated with Kappikacchu have shown mild side effects, which include headache, dystonia , fatigue, tremors, syncope and thirst. Other drugs, such as Amantadine, which improves symptoms in about 50% of the patients may cause edema, confusion, and liver reticularis. Side effects of other drugs include confusion, delirium and psychosis.
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Parkinsons: New Treatment Targets Two Nerve Systems At Once
Scientists have found that a technique for targeting a specific group of brain cells associated with Parkinsons disease is also effective at treating a separate group of brain cells.
These findings now appear in the journal Neurotherapeutics.
The initial technique is a type of gene therapy that researchers first used to target cholinergic neurons in the brains of rats in 2015. Cholinergic neurons are a type of nerve cell that Parkinsons affects.
Now, by using brain imaging techniques, the scientists have discovered that their method also positively affected a group of cells near the cholinergic neurons, called dopaminergic neurons.
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Icipating In Clinical Trials
Clinical trials and their participants have revolutionized Parkinsons treatment, and have changed the lives dramatically of those affected. They have helped make available many new treatments in addition to improving the delivery methods of medications and new deep brain stimulation techniques.
Clinical trials are essential to the future of Parkinsons research, and APDA is committed to this vital effort.
Latest Treatments For Parkinsons Disease
Researchers still have much to learn about Parkinsons disease. As researchers continue to work hard in the fight against this disease, the lessons they learn may lead to new, innovative treatments.;
Parkinsons disease is a neurodegenerative disorder that affects dopaminergic neurons in the substantia nigra area of the brain, advises the Parkinsons Foundation. Even though the disease itself is not fatal, PD is a serious condition one which the Centers for Disease Control and Prevention rates as the 14th most common cause of death in the United States due to the diseases related complications.
PD symptoms affect autonomous functions and the ability to move limbs. The Mayo Clinic notes that most people with PD may show little or no expression, speech may become slurred, arms may not swing when one walks, and stiffness and gait issues may become apparent. PD can affect balance and posture as well.
There is no cure for PD, but there are many different treatments that can slow its progress and reduce symptoms.
WebMD says new treatments for PD give individuals continued hope. Heres a look at some of the potential options.
Stem cell usagetem cells can turn into any type of cell, and there is hope that they can transform into the dopamine-producing neurons used to treat PD. But there is increased risk of involuntary movement from too much dopamine with this treatment. Stem cell therapy also may present ethical and moral issues with some patients.
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How Did Coronavirus Affect This Research
The lockdown that began in March 2020 meant that Dr Harrisons work had to be paused. But the team spent this time redesigning their project allowing them to run multiple experiments at once and hit the ground running as soon as it was safe to do so.
If; you’d like to know more,;you can read an article by;Claire Bale, Parkinson’s UK’s Head of Research Comms and Engagement blog,here
The First Step Of Many
Meanwhile, scientists have been looking into alternate ways of stimulating dopamine production.
The team from the University of Helsinki conducted experiments in cell lines and mouse models to see whether a newly discovered molecule that is similar to GDNF could be more effective.
They found that the molecule BT13 was indeed able to boost dopamine in the brains of mice.It also appeared to protect the brain cells tasked with dopamine production from dying off and, unlike GDNF, it was able to bypass the blood-brain barrier.
One of the biggest challenges for Parkinsons research is how to get drugs past the blood-brain barrier, so the exciting discovery of BT13 has opened up a new avenue for research to explore, and the molecule holds great promise as a way to slow or stop Parkinsons, comments Prof. Dexter, who was not involved in the current research.
Still, the specialist affiliated with Parkinsons UK points out, there is much work ahead of the researchers before they can confirm that the new approach works in humans.
More research is needed to turn BT13 into a treatment to be tested in clinical trials, to see if it really could transform the lives of people living with Parkinsons, he acknowledges.
Yulia Sidorova, Ph.D. the studys co-lead researcher agrees, noting that she and colleagues are already hard at work toward this end.
Our ultimate goal is to progress these compounds to clinical trials in a few coming years.
Yulia Sidorova, Ph.D.
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What Are The Symptoms Of Psychosis
Two of the most prominent symptoms are hallucinations and delusions.7 Hallucinations involve seeing, hearing, experiencing or sensing things that are not really there. Delusions are false beliefs that are not based in reality. In describing symptoms of Parkinsons disease psychosis, patients may use such common terms as: seeing things, paranoia, flashbacks, nightmares, false beliefs, or not being in touch with reality.8
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What Will A Cure For Parkinson’s Look Like
Because Parkinson’s varies so much from person to person, there may not be a single ‘cure’.
Instead we may need a range of different therapies to meet the needs of the individual and their specific form of the condition.
This mix may include treatments, therapies and strategies that can:
- slow or stop the progression of the condition
- replace or repair lost or damaged brain cells
- control and manage particular symptoms
- diagnose Parkinson’s at the earliest possible stage.
And this could involve medical treatments, such as drugs and surgical approaches, as well as lifestyle changes, for example to diet and exercise.
What Is The Glymphatic System
The glymphatic system is made up of a network of vessels that can carry this accumulated waste out of the brain. It uses cerebral spinal fluid to wash away the toxic proteins and dead cells that have built up during the day. And one of the things it washes away is alpha-synuclein, a toxic protein that is believed to play a major role in damaging brain cells in Parkinsons. ;
Watch the video to find out more
This led Dr Ian Harrison to start thinking whether the system could be harnessed to remove more of these damaging proteins. Lab tests have already shown that toxic proteins linked to Alzheimers can be cleared away by boosting the glymphatic system. Dr Harrison and his team want to find out if the same results could be replicated for people with Parkinsons.
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In this promising project, Dr Harrison and his team want to find the;best way to boost the effectiveness of the glymphatic system.;
To do this they will test 4 different methods:;
- A drug like molecule
- A small amount of alcohol
- A sugary molecule
- Exercise;; ;
The next step will be to identify which method is most effective and then;find out the levels they need to be given at. This could pave the way for;a new treatment that could stop or slow the progression of Parkinsons.;
What Is Parkinsons Disease
Parkinsons disease is a progressive brain disorder that causes shaking and muscle stiffness, and slows movement. It develops when neurons in a particular part of the brain stop working properly and are lost over time. These neurons produce an important chemical called dopamine. Dopamine is used by the brain to send messages across brain areas to help control movement. Eventually, the brain cannot make enough dopamine to control the movement properly.1,2
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Why Isnt There A Greater Awareness Of Parkinsons Disease Psychosis
Its not uncommon for people with Parkinsons disease psychosis to remain silent about their experiences.2,4,9 In fact, only 10% to 20% actually report their symptoms to their physicians.4-9 Work continues to be done to raise awareness of this condition. You can find more information on the non-motor symptoms associated with Parkinsons disease here.
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Why Scientists Believe Theyve Made New Breakthrough In Parkinsons Disease Treatment By Building On Gdnf Research
The Finnish researchers are now working to improve the properties of BT13 to make it more effective as a potential treatment that could benefit many people living with the disease.
The study, which was published online yesterday in the journal Movement Disorders, builds on previous research on another molecule that targets the same receptors in the brain.
GDNF or glial cell line-derived neurotrophic factor is an experimental treatment for Parkinsons discovered in 1993 that has been shown to bring dying brain cells back to life and particularly effective in dopamine neurons.
It was the subject of a BBC documentary in February 2019 that followed a phase two trial in Bristol involving 42 patients. While the results werent clear cut, GDNF has shown promise to restore damaged cells in people with Parkinsons.
However, the GDNF protein requires complex robot-assisted surgery to deliver the treatment to the brain because its a large molecule that cant cross the blood-brain barrier a protective wall that prevents some drugs from getting into the brain.
BT13 is a smaller molecule that is able to cross the blood-brain barrier and therefore could be more easily administered as a treatment if shown to be beneficial in further clinical trials.
Dr Yulia Sidorova, lead researcher on the study, said: We are constantly working on improving the effectiveness of BT13.
Our ultimate goal is to progress these compounds to clinical trials in a few coming years.
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Id Like To See A Specialist Can You Recommend A Doctor Who Specialises In Parkinsons
If you would like to see a specialist or a nurse who specialises in Parkinsons, you should first talk with your doctor. Referral procedures depend;where you live and your doctor will be able to suggest who else you might be able to see.
Remember that a doctor with a special interest in Parkinsons may have a different name, again, depending on which country you live in, for example a;Neurologist, a Movement Disorder Specialist, or a Consultant in the Care of the Elderly with a special interest in Parkinsons.;;
See also: Creating your;healthcare team.
Regulatory Approval & Reimbursement
The Exablate system manufactured by Insightec is approved in Europe and in the US for treating tremor-dominant Parkinson’s disease. Patients should talk with their physician if they are not sure if they have tremor-dominated Parkinsons disease. We recommend that they talk with the treatment site for questions about insurance coverage under Medicare, as some treatment sites are now being reimbursed by Medicare. Most commercial companies are not currently covering this procedure.
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Researchers Are Getting Closer To A Drug That Is Truly A Parkinsons Treatmentone That Can Halt Or Cure The Disease Instead Of Just Fighting Symptoms
As the incidence of Parkinsons growsan estimated 50,000 new cases per yearso do the options being offered by drug manufacturers.;
Todays Parkinsons treatment options address the symptoms of tremors, stiffness, and slow movement to improve quality of life. However, they do little to slow the progression of this disease.; Fortunately, research is helping us better understand Parkinsons. While early signs of Parkinsons disease can be overlooked, once its diagnosed, treatment options are expanding beyond the current drugs. So one day we may find a Parkinsons treatment that makes the disease less of a life sentence.
If you have Parkinsons disease, there arent any treatments that can slow, reverse, or stop the conditions progression, says Kara J. Wyant, M.D., in a Michigan Health blog on Parkinsons treatment. But, although there is no cure, more than a dozen medications can help patients manage symptoms. Our goals when prescribing medications for Parkinsons disease are twofold: to improve day-to-day functioning and quality of life and to keep people functioning as long as possible.