Current and Experimental Treatments of Parkinson’s Disease

Dear Colleagues,

Parkinson’s disease (PD) is the second most common age-related neurodegenerative disease. It is estimated that between seven and 10 million people suffer from PD worldwide. PD is caused by dopaminergic neuron death, and the first motor symptoms are present when over 80% of the nerve cells in the substantia nigra pars compacta have been lost.

To date, the majority of treatments developed for PD have targeted motor symptoms, and were designed to increase the level of dopamine in the brain. The gold standard, and the most common first-line treatment for PD is levodopa, with various methods of drug delivery: oral capsules and tablets, inhaled powder or via PEG-J as an intestinal gel. Dopamine agonists are also frequently prescribed as a monotherapy in younger patients or added to levodopa in older ones. Other approved therapies include monoamine oxidase-B (MAO-B) inhibitors, catechol-O-methyltransferase (COMT) inhibitors, amantadine and anticholinergics. For those PD patients who have motor symptoms that are not adequately controlled with medication, surgical treatment with deep brain stimulation (DBS) may be an option. Besides motor symptoms, many non-motor symptoms, like autonomic system failure (orthostatic hypotonia, nocturia, constipation, excessive sweating, hypersalivation), cognitive and behavioral disturbances, and sleep disorders can be even more disabling, and have a major negative influence on patients’ quality of life. For these problems, there are some treatment options, and new molecules are under investigation. Physiotherapy, speech and occupational therapy should also be considered as supportive treatments for PD, as they can improve many symptoms. With that being said, all those treatments are symptomatic, and they neither cure nor slow PD progression. Since PD is an uncurable disease, many clinical trials and research are focused on disease-modifying treatments. They target different proteins and pathways, some use viral vectors for gene delivery to the brain or delivery of the neurotrophic factors that could restore dopaminergic neuron function.

The philosophy of this Special Issue is describing the existing therapeutic possibilities for motor and non-motor symptoms of Parkinson’s disease, as well as perspectives for future disease-modifying therapies.

Dr. Joanna Siuda
Guest Editor

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• Parkinson’s disease
• pharmacological treatment
• neuromodulation
• neurotrophic factors
• deep brain stimulation
• infusion therapies
• non-pharmacological therapy
• disease modifying therapies
• quality of life