Key Clinical Trials in Pharmacological Treatment of Early Parkinson’s Disease

US Neurology ◽  
2009 ◽  
Vol 05 (01) ◽  
pp. 25
Author(s):  
Binit Shah ◽  
Tanya Simuni ◽  
◽  

Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects more than one million people in the US. The management of PD involves treatment of motor and non-motor symptoms of the disease. The armamentarium of treatment options for PD has increased substantially over the last 10 years. This article reviews recent clinical trials investigating efficacy, complications of treatment, and possible neuroprotective agents in patients with early PD.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Megan P. Feeney ◽  
Danny Bega ◽  
Benzi M. Kluger ◽  
A. Jon Stoessl ◽  
Christiana M. Evers ◽  
...  

AbstractSymptomatic management of Parkinson’s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1339 responses (17.6%). 1064 complete responses were available for analysis. Respondents represented 49 states with a mean age of 71.2 years (±8.3) and mean PD duration of 7.4 years (±6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Age and gender were found to be predictors of cannabis use in this sample (Age OR = 0.95, 95% CI 0.93 to 0.97; Male OR = 1.44, 95% CI 1.03 to 2.03). Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p = 0.03). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%), and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.


2020 ◽  
Author(s):  
Megan P. Feeney ◽  
Danny Bega ◽  
Benzi M. Kluger ◽  
A. Jon Stoessl ◽  
Christiana M. Evers ◽  
...  

AbstractSymptomatic management of Parkinson’s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1,064 complete responses for analysis (14%). Respondents represented 49 states with a mean age of 71.2 years (± 8.3) and mean PD duration of 7.4 years (± 6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p < 0.005). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%) and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.80-e4
Author(s):  
Fahd Baig ◽  
Michael Lawton ◽  
Michal Rolinski ◽  
Claudio Ruffmann ◽  
Kannan Nithi ◽  
...  

ObjectiveTo delineate treatment and quality of life of non-motor symptoms (NMS) in early Parkinson's disease (PD) and first-degree relatives.BackgroundNon-motor symptoms (NMS) are an important prodromal feature of Parkinson's disease (PD). However, their frequency, treatment rates and impact on health-related quality of life (HRQoL) in the early motor phase is unclear.Methods769 population-ascertained PD subjects within 3.5 years of diagnosis and 287 control subjects were assessed. Validated severity questionnaires were employed to assess NMS symptoms across the following domains: (1) neuropsychiatric (2) gastrointestinal (3) sleep (4) sensory (5) autonomic (6) sexual. Health related quality of life (HRQoL), functional status and management were also evaluated.ResultsNMS were common in early PD. More than half of the PD cases had hyposmia, pain, fatigue, sleep disturbance or urinary dysfunction. PD cases had worse HRQoL scores than controls (OR 4.1, p<0.001) with depression, anxiety and pain being stronger drivers than MDS-UPDRS motor scores. Quality of life is affected in early PD, although 23% of participants reported no problems. NMS were rarely treated in routine clinical practice.ConclusionsDespite their major impact on HRQoL, NMS are usually under-recognised and treated. The use of screening tools could improve recognition and treatment of NMS in early PD.


2018 ◽  
Vol 26 (3) ◽  
pp. 400-406 ◽  
Author(s):  
X. Huang ◽  
S. Y.‐E. Ng ◽  
N. S.‐Y. Chia ◽  
F. Setiawan ◽  
K.‐Y. Tay ◽  
...  

2015 ◽  
Vol 22 (8) ◽  
pp. 1145-1150 ◽  
Author(s):  
P. Zis ◽  
P. Martinez-Martin ◽  
A. Sauerbier ◽  
A. Rizos ◽  
J. C. Sharma ◽  
...  

2021 ◽  
Vol 11 (4) ◽  
pp. 467
Author(s):  
Tino Zaehle

In contrast to motor symptoms, non-motor symptoms in Parkinson’s disease (PD) are often poorly recognized and inadequately treated. Fatigue is one of the most common non-motor symptoms in PD and affects a broad range of everyday activities, causes disability, and substantially reduces the quality of life. It occurs at every stage of PD, and once present, it often persists and worsens over time. PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. However, despite its clinical significance, little progress has been made in understanding the causes of Parkinson’s disease-related fatigue (PDRF) and developing effective treatment options, which argues strongly for a greater effort. Transcranial direct current stimulation (tDCS) is a technique to non-invasively modulate cortical excitability by delivering low electrical currents to the cerebral cortex. In the past, it has been consistently evidenced that tDCS has the ability to induce neuromodulatory changes in the motor, sensory, and cognitive domains. Importantly, recent data present tDCS over the frontal cortex as an effective therapeutic option to treat fatigue in patients suffering from multiple sclerosis (MS). The current opinion paper reviews recent data on PDRF and the application of tDCS for the treatment of fatigue in neuropsychiatric disorders to further develop an idea of using frontal anodal tDCS as a potential therapeutic strategy to alleviate one of the most common and severe non-motor symptoms of PD.


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