scholarly journals Acupuncture for Parkinson’s Disease: Efficacy Evaluation and Mechanisms in the Dopaminergic Neural Circuit

2021 ◽  
Vol 2021 ◽  
pp. 1-23
Author(s):  
Yadan Zhao ◽  
Zichen Zhang ◽  
Siru Qin ◽  
Wen Fan ◽  
Wei Li ◽  
...  

Parkinson’s disease (PD) is a chronic and progressive neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra. Existing pharmaceutical treatments offer alleviation of symptoms but cannot delay disease progression and are often associated with significant side effects. Clinical studies have demonstrated that acupuncture may be beneficial for PD treatment, particularly in terms of ameliorating PD symptoms when combined with anti-PD medication, reducing the required dose of medication and associated side effects. During early stages of PD, acupuncture may even be used to replace medication. It has also been found that acupuncture can protect dopaminergic neurons from degeneration via antioxidative stress, anti-inflammatory, and antiapoptotic pathways as well as modulating the neurotransmitter balance in the basal ganglia circuit. Here, we review current studies and reflect on the potential of acupuncture as a novel and effective treatment strategy for PD. We found that particularly during the early stages, acupuncture may reduce neurodegeneration of dopaminergic neurons and regulate the balance of the dopaminergic circuit, thus delaying the progression of the disease. The benefits of acupuncture will need to be further verified through basic and clinical studies.

2020 ◽  
Vol 91 (8) ◽  
pp. e6.1-e6
Author(s):  
Peter Brown

Professor Peter Brown is Professor of Experimental Neurology and Director of the Medical Research Council Brain Network Dynamics Unit at the University of Oxford. Prior to 2010 he was a Professor of Neurology at University College London.For decades we have had cardiac pacemakers that adjust their pacing according to demand and yet therapeutic adaptive stimulation approaches for the central nervous system are still not clinically available. Instead, to treat patients with advanced Parkinson’s disease we stimulate the basal ganglia with fixed regimes, unvarying in frequency or intensity. Although effective, this comes with side-effects and in terms of sophistication this treatment approach could be compared to having central heating system on all the time, regardless of temperature. This talk will describe recent steps being taken to define the underlying circuit dysfunction in Parkinson’s and to improve deep brain stimulation by controlling its delivery according to the state of pathological activity.Evidence is growing that motor symptoms in Parkinson’s disease are due, at least in part, to excessive synchronisation between oscillating neurons. Recordings confirm bursts of oscillatory synchronisation in the basal ganglia centred around 20 Hz. The bursts of 20 Hz activity are prolonged in patients withdrawn from their usual medication and the dominance of these long duration bursts negatively correlates with motor impairment. Longer bursts attain higher amplitudes, indicative of more pervasive oscillatory synchronisation within the neural circuit. In contrast, in heathy primates and in treated Parkinson’s disease bursts tend to be short. Accordingly, it might be best to use closed-loop controlled deep brain stimulation to selectively terminate longer, bigger, pathological beta bursts to both save power and to spare the ability of underlying neural circuits to engage in more physiological processing between long bursts. It is now possible to record and characterise bursts on-line during stimulation of the same site and trial adaptive stimulation. Thus far, this has demonstrated improvements in efficiency and side-effects over conventional continuous stimulation, with at least as good symptom control in Parkinsonian patients.


2020 ◽  
Vol 19 (8) ◽  
pp. 572-583
Author(s):  
Helle Bogetofte ◽  
Arezo Alamyar ◽  
Morten Blaabjerg ◽  
Morten Meyer

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by a preferential degeneration of dopaminergic neurons in the substantia nigra pars compacta. This results in a profound decrease of striatal dopamine (DA) levels, which in turn leads to the cardinal motor symptoms of PD; muscle rigidity, hypo- and bradykinesia and resting tremor. Even 50 years after its initial use, the DA precursor levodopa (L-dopa), is still the most effective medical therapy for the symptomatic treatment of PD. Long-term L-dopa treatment is however, unfortunately associated with undesirable side effects such as motor fluctuations and dyskinesias. Furthermore, despite the disease alleviating effects of L-dopa, it is still discussed whether L-dopa has a neurotoxic or neuroprotective effect on dopaminergic neurons. Here we review the history of L-dopa, including its discovery, development and current use in the treatment of PD. We furthermore review current evidence of the L-dopa-induced side effects and perspectives of L-dopa treatment in PD compared to other established treatments such as DA-agonists and the inhibitors of catechol-o-methyltransferase and monoamine oxidase B.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ryan M. Welchko ◽  
Xavier T. Lévêque ◽  
Gary L. Dunbar

Parkinson’s disease (PD) is a neurodegenerative disease characterized by a specific loss of dopaminergic neurons. Although the vast majority of PD cases are idiopathic in nature, there is a subset that contains genetic links. Of the genes that have been linked to PD, α-synuclein and leucine-rich repeat kinase 2 have been used to develop transgenic rat models of the disease. In this paper we focused on the various transgenic rat models of PD in terms of their ability to mimic key symptoms of PD in a progressive manner. In general, we found that most of these models provided useful tools for the early stages of PD, but the development of new transgenic rats that present significant neuropathologic and motoric deficits in a progressive manner that more accurately mimics PD is needed.


2012 ◽  
Vol 1477 ◽  
pp. 59-73 ◽  
Author(s):  
Wacław Kolasiewicz ◽  
Katarzyna Kuter ◽  
Klemencja Berghauzen ◽  
Przemysław Nowak ◽  
Gert Schulze ◽  
...  

2020 ◽  
Author(s):  
Andrew Gao

AbstractParkinson’s disease (PD) affects millions of people worldwide and causes symptoms such as bradykinesia and disrupted speech. Parkinson’s disease is known to be characterized by the mass death of dopaminergic neurons in the substantia nigra region. In the status quo, PD is often diagnosed at late stages because obvious motor symptoms appear after the disease has progressed far. It is advantageous to diagnose PD before the onset of motor symptoms because treatments are often more effective at early stages. While motor symptoms usually manifest when over 50% of dopaminergic neurons in the substantia nigra are already lost, molecular signatures of PD may be present at early stages in patient blood. This study aimed to analyze several gene expression studies’ data for commonly differentially expressed genes (DEGs) in the blood of early stage PD patients. 147 DEGs were identified in at least two out of three datasets and passed cut-off criteria. A protein interaction network for the DEGs was constructed and various tools were used to identify network characteristics and hub genes. PANTHER analysis revealed that the biological process “cellular response to glucagon stimulus” was overrepresented by almost 21 times among the DEGs and “lymphocyte differentiation” by 5.98 times. Protein catabolic processes and protein kinase functions were also overrepresented. ESR1, CD19, SMAD3, FOS, CXCR5, and PRKACA may be potential biomarkers and warrant further study. Overall, the findings of the present study provide insights on molecular mechanisms of PD and provide greater confidence on which genes are differentially expressed in PD. The results also are additional evidence for the role of the immune system in PD, a topic that is gaining interest in the PD research community.


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