Parkinson’s disease: Is there a role for dietary and herbal supplements?

: Parkinson’s disease (PD) is characterised by degeneration of the neurons of the nigrostriatal dopaminergic pathway of the brain. The pharmacological cornerstone of PD management is mainly the use of dopamine precursors, dopamine receptor agonists, and agents that inhibit biochemical degradation of dopamine. While these drugs initially relief symptoms and improve the quality of life of patients, progression of the underlying pathological processes such as oxidative stress and neuroinflammation (which have been strongly associated with PD and other neurodegenerative disorders) eventually reduces their benefits; making further benefits now only achievable at high doses which amplify the magnitude and frequency of side-effects. Also, while it is becoming obvious that mainstream pharmacological agents may not always provide the much-needed answer, the question remains what succour can nature provide through dietary supplements, nutraceuticals and herbal remedies? This narrative review examines current literature for evidence of the possible roles (if any) of nutraceuticals, dietary supplements and herbal remedies in the prevention or management of PD, by examining how these compounds could modulate key factors and pathways that are crucial to the pathogenesis and/or progression of PD. The likely limitations of this approach and its possible future roles in PD prevention and management are also considered.