Update on Therapeutic Strategies for Atypical Parkinsonian Syndromes

Abstract

Atypical Parkinsonian syndromes include multiple systems atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB). These conditions show signs of dopamine deficiency, but unlike Parkinson’s disease (PD), they do not respond to dopaminergic treatments and usually have a worse outcome compared with idiopathic PD. The Atypical Parkinsonian syndromes have no specific treatment or cure. Up to now, there are just a few therapeutic approaches that place emphasis on symptomatic and supportive therapies. These approaches are based on palliative care, physical or occupational therapy, neuropsychology, speech pathology, psychiatry, and social works. Pharmacotherapy with levodopa, dopamine agonists, amantadine, co-enzyme Q10, botulinum toxin, cholinesterase inhibitors, and selective serotonin reuptake inhibitors may improve some symptoms of PSP and CBD. In this review, we categorize some of the recent studies on therapeutic strategies as follows: autologous transplantation of stem cells, deep transcranial magnetic stimulation, intravenous immunoglobulin, intranasal insulin, and pimavanserin. By classifying and comparing the most recent advances in treatment strategies of the atypical parkinsonian syndromes, we provide a benchmark for further studies to introduce new effective therapeutic methods.