Journal of Parkinson s Disease,
Journal Year:
2019,
Volume and Issue:
10(1), P. 31 - 45
Published: Dec. 17, 2019
The
global
prevalence
of
Parkinson's
disease
is
increasing,
yet
the
characteristics,
risk
factors
and
genetics
PD
in
Black,
Asian
Hispanic
populations
little
understood.In
this
paper
we
review
published
literature
on
clinical
variation
symptoms
signs
different
ethnic
groups
responses
to
treatment.We
included
any
study
that
sampled
patients
with
from
distinct
backgrounds.We
conclude
whilst
there
evidence
for
features
disease,
are
substantial
limitations
gaps
current
literature,
which
mean
does
necessarily
not
fit
observation.Possible
explanations
expected
differences
manifestation
include
genetic
determinants,
co-existence
cerebrovascular
and/or
Alzheimer's
pathology,
healthcare
inequalities
socio-cultural
factors.
JAMA,
Journal Year:
2020,
Volume and Issue:
323(6), P. 548 - 548
Published: Feb. 11, 2020
Importance
Parkinson
disease
is
the
most
common
form
of
parkinsonism,
a
group
neurological
disorders
with
disease–like
movement
problems
such
as
rigidity,
slowness,
and
tremor.
More
than
6
million
individuals
worldwide
have
disease.
Observations
Diagnosis
based
on
history
examination.
History
can
include
prodromal
features
(eg,
rapid
eye
sleep
behavior
disorder,
hyposmia,
constipation),
characteristic
difficulty
tremor,
stiffness,
slowness),
psychological
or
cognitive
decline,
depression,
anxiety).
Examination
typically
demonstrates
bradykinesia
both.
Dopamine
transporter
single-photon
emission
computed
tomography
improve
accuracy
diagnosis
when
presence
parkinsonism
uncertain.
has
multiple
variants
different
prognoses.
Individuals
diffuse
malignant
subtype
(9%-16%
disease)
prominent
early
motor
nonmotor
symptoms,
poor
response
to
medication,
faster
progression.
mild
motor-predominant
(49%-53%
good
dopaminergic
medications
carbidopa-levodopa,
dopamine
agonists),
slower
Other
an
intermediate
subtype.
For
all
patients
disease,
treatment
symptomatic,
focused
improvement
in
bradykinesia)
constipation,
cognition,
mood,
sleep)
signs
symptoms.
No
disease-modifying
pharmacologic
treatments
are
available.
Dopamine-based
therapies
help
initial
Nonmotor
symptoms
require
nondopaminergic
approaches
selective
serotonin
reuptake
inhibitors
for
psychiatric
cholinesterase
cognition).
Rehabilitative
therapy
exercise
complement
treatments.
experiencing
complications,
worsening
functional
impairment
medication
dose
wears
off
("off
periods"),
medication-resistant
dyskinesias,
benefit
from
advanced
levodopa-carbidopa
enteral
suspension
deep
brain
stimulation.
Palliative
care
part
management.
Journal of Neurology Neurosurgery & Psychiatry,
Journal Year:
2020,
Volume and Issue:
91(8), P. 795 - 808
Published: June 23, 2020
The
concept
of
‘idiopathic’
Parkinson’s
disease
(PD)
as
a
single
entity
has
been
challenged
with
the
identification
several
clinical
subtypes,
pathogenic
genes
and
putative
causative
environmental
agents.
In
addition
to
classic
motor
symptoms,
non-motor
manifestations
(such
rapid
eye
movement
sleep
disorder,
anosmia,
constipation
depression)
appear
at
prodromic/premotor
stage
evolve,
along
cognitive
impairment
dysautonomia,
progresses,
often
dominating
advanced
stages
disease.
key
molecular
mechanisms
include
α-synuclein
misfolding
aggregation,
mitochondrial
dysfunction,
protein
clearance
(associated
deficient
ubiquitin-proteasome
autophagy-lysosomal
systems),
neuroinflammation
oxidative
stress.
involvement
dopaminergic
well
noradrenergic,
glutamatergic,
serotonergic
adenosine
pathways
provide
insights
into
rich
variable
phenomenology
associated
PD
possibility
alternative
therapeutic
approaches
beyond
traditional
dopamine
replacement
therapies.
One
biggest
challenges
in
development
potential
neuroprotective
therapies
lack
reliable
sensitive
biomarkers
progression.
Immunotherapies
such
use
vaccination
or
monoclonal
antibodies
directed
against
aggregated,
toxic
α-synuclein.as
anti-aggregation
strategies
are
currently
investigated
trials.
application
glucagon-like
peptide
one
receptor
agonists,
specific
gene
target
agents
GBA
LRRK2
modifiers)
other
modifying
drugs
cautious
optimism
that
more
effective
on
horizon.
Emerging
therapies,
new
symptomatic
drugs,
innovative
drug
delivery
systems
novel
surgical
interventions
give
hope
patients
about
their
future
outcomes
prognosis.
Biomolecules,
Journal Year:
2021,
Volume and Issue:
11(4), P. 612 - 612
Published: April 20, 2021
Parkinson’s
disease
(PD)
usually
presents
in
older
adults
and
typically
has
both
motor
non-motor
dysfunctions.
PD
is
a
progressive
neurodegenerative
disorder
resulting
from
dopaminergic
neuronal
cell
loss
the
mid-brain
substantia
nigra
pars
compacta
region.
Outlined
here
an
integrative
medicine
health
strategy
that
highlights
five
treatment
options
for
people
with
(PwP):
rehabilitate,
therapy,
restorative,
maintenance,
surgery.
Rehabilitating
begins
following
diagnosis
throughout
any
additional
processes,
especially
vis-à-vis
consulting
physical,
occupational,
and/or
speech
pathology
therapist(s).
Therapy
uses
daily
administration
of
either
dopamine
precursor
levodopa
(with
carbidopa)
or
agonist,
compounds
preserve
residual
dopamine,
other
specific
motor/non-motor-related
compounds.
Restorative
strenuous
aerobic
exercise
programs
can
be
neuroprotective.
Maintenance
complementary
alternative
substances
potentially
support
protect
brain
microenvironment.
Finally,
surgery,
including
deep
stimulation,
pursued
when
PwP
fail
to
respond
positively
options.
There
currently
no
cure
PD.
In
conclusion,
best
treating
hope
slow
progression
strive
achieve
stability
neuroprotection.
The
ultimate
goal
management
program
improve
quality-of-life
person
disease.
