Emerging and alternative therapies for Parkinson disease: an updated review.

Parkinson's disease (PD) is one of the most common neurodegenerative disorder with intricate progressive pathology. Currently, available conventional options for PD have certain limitations of their own, and as a result, patient compliance and satisfaction are low. Current contemporary treatment options provide only symptomatic relief with limited control to prevent disease progression, resulting in poor patient compliance and satisfaction. Several emerging pharmacotherapies for PD are in different stages of clinical development. These therapies include adenosine A2A receptor antagonists, glutamate receptor antagonists, monoamine oxidase inhibitors, anti-apoptotic agents, and antioxidants such as coenzyme Q10, N-acetyl cysteine, and edaravone. Other emerging nonpharmacotherapies include viral vector gene therapy, microRNAs, transglutaminases, RTP801, stem cells and glial-derived neurotrophic factor (GDNF). In addition, surgical procedures including deep brain stimulation, pallidotomy, thalamotomy and gamma knife surgery have emerged as alternative interventions for advanced PD patients who have completely utilized standard treatments and still suffer from persistent motor fluctuations. Complementary and Alternative medicine (CAM) modalities such as Yoga, acupuncture, Tai Chi, music therapies etc. are highly practiced in several countries, offer some of the safer and effective treatment modalities for PD. While several of these therapies hold much promise in delaying the onset of the disease and slowing its progression, more pharmacotherapies and surgical interventions need to be investigated in different stages of PD. It is hoped that these emerging therapies and surgical procedures will strengthen our clinical armamentarium for improved treatment of PD.

PMID: 30124146 DOI: 10.2174/1381612824666180820150150