Managing the patient with newly diagnosed Parkinson disease

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The treatment of early Parkinson disease (PD) is generally symptomatic, although therapy that also offers neuroprotection in early-stage PD would be welcomed. Levodopa remains the most effective agent for relief of PD symptoms, but chronic levodopa therapy is associated with motor fluctuations and dyskinesias, and clinicians may therefore opt to postpone its use. Alternatives to levodopa in early PD include monoamine oxidase (MAO)-B inhibitors, amantadine, and dopamine agonists. MAO-B inhibitors have only mild symptomatic effects. Amantadine is associated with improvement in functional disability and, in a subset of PD patients, a robust symptomatic improvement. Dopamine agonists improve symptoms and may have a neuroprotective effect. Partial dopamine agonists, adenosine A2A-receptor antagonists, and safinamide are symptomatic therapies that are under investigation. Neuro protective strategies under study include enhancement of mitochondrial function, antiinflammatory mechanisms, calcium channel blockade, and uric acid elevation. Deep brain stimulation may slow cognitive and motor decline when used in early PD. Stem cell therapy and gene therapy are still under investigation.

Original languageEnglish
JournalCleveland Clinic Journal of Medicine
Volume79
Issue numberSUPPL.2
DOIs
StatePublished - Jan 1 2012

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Parkinson Disease
Dopamine Agonists
Levodopa
Amantadine
Monoamine Oxidase Inhibitors
Monoamine Oxidase
Adenosine A2 Receptor Antagonists
Deep Brain Stimulation
Dyskinesias
Neuroprotective Agents
Calcium Channels
Therapeutics
Cell- and Tissue-Based Therapy
Uric Acid
Genetic Therapy
Anti-Inflammatory Agents
Stem Cells

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Managing the patient with newly diagnosed Parkinson disease. / Singer, Carlos.

In: Cleveland Clinic Journal of Medicine, Vol. 79, No. SUPPL.2, 01.01.2012.

Research output: Contribution to journalArticle

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