Article

Evidence-based medical review update: Pharmacological and surgical treatments of Parkinson's disease: 2001 to 2004

Department of Neurological Sciences, Department of Pharmacology, Rush University Medical Center, Chicago, Illinois 60612, USA.
Movement Disorders (Impact Factor: 5.63). 05/2005; 20(5):523-39. DOI: 10.1002/mds.20464
Source: PubMed

ABSTRACT The objective of this study is to update a previous evidence-based medicine (EBM) review on Parkinson's disease (PD) treatments, adding January 2001 to January 2004 information. The Movement Disorder Society (MDS) Task Force prepared an EBM review of PD treatments covering data up to January 2001. The authors reviewed Level I (randomized clinical trials) reports of pharmacological and surgical interventions for PD, published as full articles in English (January 2001-January 2004). Inclusion criteria and ranking followed the original program and adhered to EBM methodology. For Efficacy Conclusions, treatments were designated Efficacious, Likely Efficacious, Non-Efficacious, or Insufficient Data. Four clinical indications were considered for each intervention: prevention of disease progression; treatment of Parkinsonism, as monotherapy and as adjuncts to levodopa where indicated; prevention of motor complications; treatment of motor complications. Twenty-seven new studies qualified for efficacy review, and others covered new safety issues. Apomorphine, piribedil, unilateral pallidotomy, and subthalamic nucleus stimulation moved upward in efficacy ratings. Rasagiline, was newly rated as Efficacious monotherapy for control of Parkinsonism. New Level I data moved human fetal nigral transplants, as performed to date, from Insufficient Data to Non- efficacious for the treatment of Parkinsonism, motor fluctuations, and dyskinesias. Selegiline was reassigned as Non-efficacious for the prevention of dyskinesias. Other designations did not change. In a field as active in clinical trials as PD, frequent updating of therapy-based reviews is essential. We consider a 3-year period a reasonable time frame for published updates and are working to establish a Web-based mechanism to update the report in an ongoing manner.

0 Bookmarks
 · 
65 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Parkinson's disease (PD) is a neurological disorder characterized by tremors, rigidity and bradykinesia. PD is caused by selective degeneration of the dopaminergic neurons, which originate in the substantia nigra pars compacta (SNc) and project into the striatum. Levodopa is the most effective drug, used in the treatment of PD. However, the long-term use of levodopa produce complications which are highly disabling fluctuations and dyskinesias and representing one of the major challenge to the existing drug therapy of PD. Recent studies has indicated that the pulsatile stimulation of striatal postsynaptic receptors led to sensitization of dopaminergic receptors which leads to levodopa induced dyskinesias. In spite of the extensive research in this field, the pathogenesis of levodopa induced dyskinesia is still unclear. In recent years animal models of PD has provided important information to understand the effect of specific receptors and post-receptor molecular mechanisms underlying the development of dyskinetic movements. The present review is aimed to discuss the neurobiological mechanisms of levodopa induced dyskinesia and the therapeutic strategies to overcome this problem. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    Biomedecine [?] Pharmacotherapy 02/2015; 70. DOI:10.1016/j.biopha.2015.01.029 · 2.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Compared to deep brain electrical stimulation, which has been applied to treating pathological brain diseases, little work has been done on the effect of deep brain light stimulation. A fiber-coupled laser stimulator at 840 nm wavelength and 130 Hz pulse repetition rate is developed in this work for deep brain light stimulation in a rat model. Concentration changes in glutamate and dopamine in the striatum are observed using a microdialysis probe when the subthalamic nucleus (STN) is stimulated at various optical power levels. Experimental results show that light stimulation causes the concentration of glutamate to decrease while that of dopamine is increased. This suggests that deep brain light stimulation of the STN is a promising therapeutic strategy for dopamine-related diseases such as Parkinson's disease. The stimulator developed for this work is useful for deep brain light stimulation in biomedical research.
    Biomedical Optics Express 01/2015; 6(1):23-31. DOI:10.1364/BOE.6.000023 · 3.50 Impact Factor
  • Neurologia i neurochirurgia polska 01/2012; 46(1):63-75. DOI:10.5114/ninp.2012.27450 · 0.54 Impact Factor

Full-text (2 Sources)

Download
54 Downloads
Available from
May 23, 2014