scholarly journals Motor and nonmotor complications in Parkinson’s disease: an argument for continuous drug delivery?

2013 ◽  
Vol 120 (9) ◽  
pp. 1305-1320 ◽  
Author(s):  
K. Ray Chaudhuri ◽  
Alexandra Rizos ◽  
Kapil D. Sethi
2009 ◽  
Vol 4 (2) ◽  
pp. 24
Author(s):  
Santiago Perez Lloret ◽  
Olivier Rascol ◽  
◽  

Background: Rotigotine, a non-ergot dopamine agonist, has been developed as a novel transdermal formulation. The rotigotine transdermal patch is approved by the regulatory authorities for use in all stages of Parkinson’s disease (PD) in Europe and for early-stage PD in the US. For patients with advanced-stage PD and motor fluctuations, approved doses range from 4mg/24 hours to 16mg/24 hours. The rotigotine patch offers a certain number of potential advantages, including faster onset as intestinal absorption is not needed, continuous drug delivery and ease of use via application of a once-daily adhesive patch. An interesting element of this profile is continuous drug delivery, which may avoid the pulsatile dopaminergic stimulation that has been postulated to be related to the development of motor complications.Objective: The aim of this article is to review the pharmacokinetics, pharmacodynamics and clinical efficacy and tolerability of the rotigotine transdermal patch.Methods: Source material was identified using a PubMed search for the term ‘rotigotine’ in articles published up to October 2009 and a review of published congress abstracts. The review focused primarily on publications related to the rotigotine indication for advanced PD.Results and conclusions: The rotigotine transdermal patch demonstrates clinical efficacy and a tolerability profile that appears to be well within the range of that observed with other non-ergot dopamine agonists, except for local skin reactions, which are common with the rotigotine patch. The once-daily patch formulation may encourage compliance; however, as is the case for other theoretical advantages of continuous drug delivery, such as reduced emergence of motor complications and improved tolerance of peripheral adverse events, this requires further detailed study.


CNS Drugs ◽  
2013 ◽  
Vol 28 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Marina Senek ◽  
Dag Nyholm

2020 ◽  
Vol 26 (37) ◽  
pp. 4721-4737 ◽  
Author(s):  
Bhumika Kumar ◽  
Mukesh Pandey ◽  
Faheem H. Pottoo ◽  
Faizana Fayaz ◽  
Anjali Sharma ◽  
...  

Parkinson’s disease is one of the most severe progressive neurodegenerative disorders, having a mortifying effect on the health of millions of people around the globe. The neural cells producing dopamine in the substantia nigra of the brain die out. This leads to symptoms like hypokinesia, rigidity, bradykinesia, and rest tremor. Parkinsonism cannot be cured, but the symptoms can be reduced with the intervention of medicinal drugs, surgical treatments, and physical therapies. Delivering drugs to the brain for treating Parkinson’s disease is very challenging. The blood-brain barrier acts as a highly selective semi-permeable barrier, which refrains the drug from reaching the brain. Conventional drug delivery systems used for Parkinson’s disease do not readily cross the blood barrier and further lead to several side-effects. Recent advancements in drug delivery technologies have facilitated drug delivery to the brain without flooding the bloodstream and by directly targeting the neurons. In the era of Nanotherapeutics, liposomes are an efficient drug delivery option for brain targeting. Liposomes facilitate the passage of drugs across the blood-brain barrier, enhances the efficacy of the drugs, and minimize the side effects related to it. The review aims at providing a broad updated view of the liposomes, which can be used for targeting Parkinson’s disease.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Carmen Gasca-Salas ◽  
Beatriz Fernández-Rodríguez ◽  
José A. Pineda-Pardo ◽  
Rafael Rodríguez-Rojas ◽  
Ignacio Obeso ◽  
...  

AbstractMR-guided focused ultrasound (MRgFUS), in combination with intravenous microbubble administration, has been applied for focal temporary BBB opening in patients with neurodegenerative disorders and brain tumors. MRgFUS could become a therapeutic tool for drug delivery of putative neurorestorative therapies. Treatment for Parkinson’s disease with dementia (PDD) is an important unmet need. We initiated a prospective, single-arm, non-randomized, proof-of-concept, safety and feasibility phase I clinical trial (NCT03608553), which is still in progress. The primary outcomes of the study were to demonstrate the safety, feasibility and reversibility of BBB disruption in PDD, targeting the right parieto-occipito-temporal cortex where cortical pathology is foremost in this clinical state. Changes in β-amyloid burden, brain metabolism after treatments and neuropsychological assessments, were analyzed as exploratory measurements. Five patients were recruited from October 2018 until May 2019, and received two treatment sessions separated by 2–3 weeks. The results are set out in a descriptive manner. Overall, this procedure was feasible and reversible with no serious clinical or radiological side effects. We report BBB opening in the parieto-occipito-temporal junction in 8/10 treatments in 5 patients as demonstrated by gadolinium enhancement. In all cases the procedures were uneventful and no side effects were encountered associated with BBB opening. From pre- to post-treatment, mild cognitive improvement was observed, and no major changes were detected in amyloid or fluorodeoxyglucose PET. MRgFUS-BBB opening in PDD is thus safe, reversible, and can be performed repeatedly. This study provides encouragement for the concept of BBB opening for drug delivery to treat dementia in PD and other neurodegenerative disorders.


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