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Parkinson’s Awareness Month: Updates in Parkinson’s Disease Diagnosis and Treatment

Parkinson’s disease is the second most common progressive neurodegenerative disorder worldwide. In Canada alone, more than 100,000 people have Parkinson’s disease (approximately 1 in 500 people). Furthermore, the number of Canadians living with Parkinsonism is expected to double by 2031. 

In light of these alarming stats, it’s crucial to spread awareness regarding this devastating disease. Hence, April has been designated as Parkinson’s Awareness Month. To honour and promote this spirit of Parkinson’s awareness, here’s some of the latest information on Parkinson’s disease diagnosis and treatment to broaden your horizons.

Updates in Parkinson’s Disease Diagnosis

Parkinson’s disease is mainly diagnosed clinically through medical history and motor or movement-related symptoms like tremors, stiffness, and balance issues. However, this disease can also present with non-motor symptoms like: 

  • fatigue
  • sleep issues
  • respiratory problems
  • speech or swallowing difficulties
  • cognitive changes 
  • diminished sensory function
  • digestive issues
  • decreased bone health
  • urinary incontinence
  • mental illnesses like behaviour (hallucinations, delusions, dementia) and mood disorders 

Parkinson’s research remains focused on identifying definitive biomarkers to accurately measure disease activity, progression, and treatment effectiveness. At the molecular level, abnormal clusters of misfolded alpha-synuclein proteins are characteristic of Parkinson’s disease. Thus, spinal taps and skin (including nerve) biopsies to detect this protein may come in handy while trying to make a conclusive Parkinson’s diagnosis. Other diagnostic modalities include the use of positron emission tomography (PET) scans to identify alpha-synuclein accumulation in the brain. Alpha-synuclein radiotracers are still being developed.

Since a lack of dopamine neurotransmitter stimulation is mainly responsible for the motor symptoms of Parkinson’s disease, dopamine transporters (daT) have become one of the most popular biomarkers to be studied. These can be detected through brain imaging technology like daTscan, which uses a radioactive chemical to identify areas of the brain where dopamine-producing neurons have been lost. 

Biomarkers assessing the function of the autonomic nervous system are also being researched since non-motor symptoms can precede motor symptoms in many Parkinson’s disease cases.  

Updates in Parkinson’s Disease Therapy

While there’s still no definitive cure for Parkinson’s, levodopa has been the mainstay of treatmenttreatment since the 1960s. The efficacy of levodopa therapy remains undisputed, but the use of novel delivery systems like biodegradable polymer polylactic-glycolic acid (PLGA), and liposomes are now being explored to enhance drug delivery to the brain. 

Patients with possible diagnosis of Parkinson disease may also benefit from a trial of dopamine replacement therapy to help with diagnosis.

Furthermore, scientists are looking to repurpose drugs that suppress the immune system (azathioprine), affect other bodily functions (e.g., iron chelators like deferiprone and calcium channel blockers like isradipine), or are usually used for other indications (e.g., cough medications like ambroxol) to mitigate Parkinson’s disease symptoms. 

Some of the most popular alternative treatment modalities being researched include:

  1. immunotherapies via monoclonal antibodies
  2. stem cell therapy
  3. gene therapy
  4. deep brain stimulation
  5. regenerative therapies

Meanwhile, neuroprotective and symptomatic treatment remains the current focus of Parkinson’s disease management. This can involve supportive treatments like physical therapy for motor symptoms, and speech therapy for non-motor symptoms like speech impediments.

Thus, although disease cases are on the rise, Parkinson’s research is trying its best to catch up to a cure at the earliest.

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