• Introduction

• Epidemiology

• Symptoms

• Pathology

• Aetiology

• Overview

• Pharmacological

• Other methods

Overview

Although there is presently no cure for the ongoing neurodegeneration that occurs in PD, it is possible to treat the symptoms. There are a number of pharmacological and surgical approaches currently in use, with more in the pipeline. (Surgery and drug treatments are often combined for greater effectiveness.)

Pharmacological Therapies

Most current drug therapies centre around the action of dopamine, the neurotransmitter depleted in PD. Modes of action can involve increasing dopamine levels (by supplying a precursor, L-DOPA, or inhibiting the metabolism of dopamine to DOPAC) or enhancing the effects of the neurotransmitter (inreasing dopamine release or receptor response).

In addition to dopamine-based therapies, there are also drugs that target other neural systems affected by the dopamine decrease, such as the cholinergic and GABAergic systems. Both systems are normally inhibited by dopamine and become over-active in its absence. Anti-cholinergic substances and GABA antagonists can counteract this.

Problems with pharmacological treatments — especially when used over a long period of time — include loss of efficacy and development of side-effects. However, unlike certain surgical methods, drug regimes can be modified or halted if necessary.

Other Methods

Surgical methods of treatment involve either lesioning or device implantation. In the former approach, (called functional therapy) the brain region responsible for the symptoms is inactivated. This treatment in often used in conjunction with drug therapy and can greatly relieve the drug's side-effects. A similar effect can be achieved by implantation of a high-frequency stimulator within the brain. This has the advantage of being reversible, but is much higher maintenance, often requiring adjustment after implantation. (It is also more expensive than functional surgery.) Other implanted devices include drug delivery systems.