New Developments in Parkinson's Disease Management

Abstract

Beginning with the introduction of levodopa in late sixties there has been substantial advancement in the treatment of Parkinson's disease (PD) bringing about revoutionary modifications both in the quality of life and life expectancy of patients with PD. On the contrary, the number of controversial issues on the topic are now more than ever. We are still unable to say certainly whether selegiline or dopamine agonists are neuroprotective. whether levodopa is toxic, whether motor fluctuations and dyskinesias are caused by levodopa, whether dopamin agonists are clinically different from each other. Furthermore, the role of new dopamine agonists, catchol-o-methyltransferase inhibitors and surgical treatment are still unsettled. The success in preclinical studies about the efficacy of gene therapy, inhibition of some enzymes promoting apoptosis, treatment with certain neurotrophic factors, and inhibition or activation of dopaminergic transporters in the treatment of PD helps us to stand the existing confusion.