Therapeutic Development

TherapeuticsJohann Scultetus (1595-1645)The development of treatments for Parkinson’s disease focuses on:

• Symptomatic therapies that are palliative in nature.
• Disease-modifying therapies that aim to alter the underlying PD process and reverse or prevent further neuronal dysfunction and death.

There are effective palliative therapies for some symptoms of PD, but they all lose effectiveness as the disease progresses. Many symptomatic therapies are designed to address the hallmark features of PD by increasing dopaminergic transmission and offsetting the loss of nigrostriatal dopaminergic neurons. Some symptomatic therapies (particularly those that involve dopamine replacement) are associated with onerous side-effects such as dyskinesia, which themselves become targets for treatment.

There are currently no approved disease-modifying therapies for PD, but numerous lines of research are being pursued in pre-clinical and clinical studies. As in all disease research, therapeutic development depends largely on the existence of research models of the disease in which experimental treatments can be developed and tested before clinical testing. Due to the lack of definitive information about the causes and mechanisms of PD, currently available research models capture certain aspects of PD but do not fully reproduce the underlying disease process. An authentic model of the disease process would greatly aid further therapeutic development and is a highly active area of research.