What are the recent developments in Parkinson's disease research?

From the Guidelines

Recent developments in Parkinson's disease research have focused on improving motor function and quality of life, with a strong emphasis on personalized treatment approaches and the use of wearable technology and artificial intelligence to monitor symptoms and adjust medication regimens, as seen in the most recent study from 2022 1.

Key Areas of Research

• Genetic markers: identifying new genetic markers associated with the disease, such as mutations in the GBA and LRRK2 genes, which may lead to more targeted treatments.
• Neuroimaging techniques: developing improved neuroimaging techniques that can detect dopamine depletion earlier, potentially allowing for earlier intervention.
• Disease-modifying therapies: several disease-modifying therapies are in clinical trials, including drugs targeting alpha-synuclein aggregation, such as antibodies and small molecules that prevent protein misfolding.
• Stem cell therapies: trials exploring the transplantation of dopamine-producing neurons to replace those lost in the disease.
• Gut-brain connection: investigating the gut-brain connection in Parkinson's, as evidence suggests that alpha-synuclein pathology may begin in the enteric nervous system before spreading to the brain.

Monitoring and Treatment

• Wearable technology: using wearable technology to monitor symptoms and personalize treatment approaches, allowing for more precise medication adjustments and improved quality of life for patients.
• Artificial intelligence: developing artificial intelligence to analyze data from wearable technology and other sources, providing insights into disease progression and treatment efficacy.
• Motor function assessment: using validated scales such as the UPDRS to measure parkinsonism and incorporating surveys for falls, as recommended in the 2022 study 1.

Nutrition and Swallowing

• Malnutrition: monitoring nutritional status routinely throughout the natural history of the disease, as malnutrition is a common issue in Parkinson's disease patients, affecting up to 15% of community-dwelling patients and 24% of patients at medium or high risk of malnutrition 1.
• Dysphagia: using techniques such as thermal-tactile stimulation, surface electrical stimulation, and repetitive transcranial magnetic stimulation to improve swallow timing and reduce pharyngeal transit time in people with Parkinson's disease, as explored in the 2018 study 1.

From the FDA Drug Label

The effectiveness of pramipexole dihydrochloride tablets in the treatment of Parkinson's disease was evaluated in a multinational drug development program consisting of seven randomized, controlled trials Three were conducted in patients with early Parkinson's disease who were not receiving concomitant levodopa, and four were conducted in patients with advanced Parkinson's disease who were receiving concomitant levodopa Among these seven studies, three studies provide the most persuasive evidence of pramipexole's effectiveness in the management of patients with Parkinson's disease who were and were not receiving concomitant levodopa

The FDA drug label does not answer the question.

From the Research

Recent Developments in Parkinson's Disease Research

• Parkinson's disease (PD) is the second most common neurodegenerative disorder, and its global incidence is on the rise 2.
• Current dopaminergic pharmacotherapy for PD consists of levodopa and other dopaminergic drugs, such as dopamine agonists and monoamine oxidase B (MAOB) inhibitors 2.
• Non-dopaminergic pharmacological approaches, including zonisamide and istradefylline, are also available for the treatment of PD 2.
• Device-aided therapies, such as deep brain stimulation and levodopa-carbidopa intestinal gel infusion therapy, can be performed at the advanced stage of PD 2.

Pharmacological Treatments for PD

• Catechol-O-methyltransferase (COMT) inhibitors, such as entacapone and tolcapone, are used to improve the pharmacokinetics of levodopa and reduce motor fluctuations in patients with advanced PD 3, 4.
• Dopamine agonists, such as pramipexole and ropinirole, are effective as monotherapy or adjunctive therapy in patients with early or advanced PD 3, 5.
• Levodopa remains the most potent dopaminergic therapy for PD, and its clinical use may be limited by the development of treatment-related complications, such as response fluctuations and dyskinesia 6.

Emerging Trends in PD Treatment

• Recent developments in treatment with levodopa aim to achieve continuous delivery, including duodenal infusion of levodopa/carbidopa, transdermal levodopa patch, and oral pro-levodopa 6.
• The use of COMT inhibitors, such as opicapone, has shown promise in reducing off-time and improving motor symptoms in patients with advanced PD 4.
• The combination of COMT inhibitors with new formulations of levodopa may improve the management of motor fluctuations in patients with PD 4.