[Therapeutic strategies for Parkinson's disease and guidelines for the 21st century].
Parkinson's disease(PD) is one of the most common neurodegenerative disorders, characterized clinically by resting tremor, rigidity and akinesia. The pathological hallmarks of PD is the loss of neurons of the substantia nigra and the existence of Lewy bodies. Among multifactorial theories of gene-environment interaction supporting the pathogenesis of this disease, recent topics focus on the findings of single gene mutations found in several forms of familial PDs. The mutations of the gene encode the protein alpha-synuclein, UCH-L1 and Parkin located on the chromosomes 4q21-23, 4p and 6p25.2-27 respectively. Molecular pathology and histochemical studies reveal that one of these proteins is closely associated with parts of Lewy bodies, or has the function of the ubiqitin system of protein metabolism. Although the typical PD shows good response to levodopa therapy, its side effects, which arise after 5 to 10 years of treatment, rather narrow the therapeutic window of PD. As a result we must make available various new therapeutic tools in order to prevent disability and get a favourable QOL in the PD patient's life span. The various tools adopted here include surgical treatments, transcraial magnetic stimulation methods, nonconvulsive electric stimulation therapy, and the design of new drugs. In this issue the frontier of PD therapy and research will be reviewed and new promising insights and guidelines for the current century will be discussed.
Yuasa
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Department of Neurology, Kohnodai Hospital.
D005544:Forecasting; D006801:Humans; D010300:Parkinson Disease / Q000209:etiology / Q000628:therapy; D013812:Therapeutics / Q000639:trends*