Intracerebroventricular dopamine for Parkinson's disease

Pathophysiological Mechanisms and Experimental Pharmacotherapy for L-Dopa-Induced Dyskinesia

L-dopa-induced dyskinesia (LID) is the most frequent motor complication associated with chronic L-dopa treatment in Parkinson’s disease (PD). Recent advances in the understanding of the pathophysiological mechanisms underlying LID suggest that abnormalities in multiple neurotransmitter systems, in addition to dopaminergic nigrostriatal denervation and altered dopamine release and reuptake dynamics at the synaptic level, are involved in LID development. Increased knowledge of neurobiological LID substrates has led to the development of several drug candidates to alleviate this motor complication. However, with the exception of amantadine, none of the pharmacological therapies tested in humans have demonstrated clinically relevant beneficial effects. Therefore, LID management is still one of the most challenging problems in the treatment of PD patients. In this review, we first describe the known pathophysiological mechanisms of LID. We then provide an updated report of experimental pharmacotherapies tested in clinical trials of PD patients and drugs currently under study to alleviate LID. Finally, we discuss available pharmacological LID treatment approaches and offer our opinion of possible issues to be clarified and future therapeutic strategies.

Biosensors in Parkinson's disease

Parkinson's disease (PD) is one of the most critical disorders of the elderly and strongly associated with increased disability, and reduced quality of life. PD is a progressive neurodegenerative disease affecting more than six million people worldwide. Evaluation of clinical manifestations, as well as movement disorders by a neurologist and some routine laboratory tests are the most important diagnostic methods for PD. However, routine and old methods have several disadvantages and limitations such as low sensitivity and selectivity, high cost, and need for advanced equipment. Biosensors technology opens up new diagnoses approach for PD with the use of a new platform that allows reliable, repeatable, and multidimensional identification to be made with minimal problem and discomfort for patients. For instance, biosensing systems can provide promising tools for PD treatment and monitoring. Amongst biosensor technology, electrochemical techniques have been at the frontline of this progress, thanks to the developments in material science, such as gold nanoparticles (AuNPs), quantum dots (QDs), and carbon nanotubes (CNTs). This paper evaluates the latest progress in electrochemical and optical biosensors for PD diagnosis.

Intrathecal and intracerebroventricular dopamine for Parkinson's disease

While CDD directly to the CSF can provide a constant delivery of the dopaminergic drug resulting in a more stable treatment effect without the limitations of traditional oral therapy without peripheral effects, it is still young and longitudinal data is lacking. These experimental therapies show promise and further investigation into their efficacy and safety could extend the frontiers for management of PD.