Treatments for Parkinson’s disease are advancing
Parkinson’s disease currently affects nearly one million Americans with no specific known cause and no cure. Treatments have come a long way over the past few decades focusing on managing symptoms and improving quality of life through medication, surgical options like deep brain stimulation, and supportive therapies like physiotherapy and occupational therapy. However, newer treatments are emerging, and some clinical trials are showing promise in targeting some parts of the disease.
Some of the new treatment approaches involve infusions under a patient’s skin. Vyalev is a treatment that uses levodopa and carbidopa under the skin to help improve symptoms and body control. Onapgo is another subcutaneous infusion therapy that uses apomorphine to help manage tremors and other motor symptoms. Another new area of research and treatment involves cell-based therapies such as bemdaneprocel, which works to replace dopamine-producing neurons that are destroyed with Parkinson’s disease. The therapy involves replacing these by transplanting dopaminergic neuron precursor cells.
“We don’t have any disease-modifying treatments to this point, but the good part is we do have a host of different medications,” explains Dr. Timothy Leichliter, a neurologist with Allegheny Health Network (AHN). “It’s not just the typical carbidopa, levodopa that’s been around since the 1960s; we have other medication options.”
Surgical treatments have been around for a while now, but there has also been some notable progress in deep brain stimulation (DBS) techniques. This surgery involves implanting electrodes into specific areas of the brain to treat movement disorders. The adaptive generation of these DBS procedures now involve recording a patient’s brain activity and adjusting the stimulation in real-time to get better results. Ultrasound is also a new area of research in Parkinson’s treatment with minimally invasive MRI-guided focused ultrasound being used to help target these specific areas of the brain involving the cause of tremors.
“Even in the world of deep brain stimulation, which we’ve been doing for 20 plus years, the techniques are newer,” says Leichliter. “There’s technology that’s newer, so we’re making gradual improvements in the treatment options, but we still just don’t have that disease-modifying medication, or that cure or that preventative game changer.”
Gene therapy is showing promise by introducing a gene into the brain that could potentially protect neurons and restore those that produce dopamine, which is critical to motor movement. On the horizon, clinicals trials are ongoing for several promising new therapies.
With no available cure, the best advice doctors give to Parkinson’s patients is to keep moving as much as possible.
“I talk heavily about exercise and staying active and being healthy and eating right because there’s a little bit written about the Mediterranean diet being the best for Parkinson’s disease,” says Leichliter. “We think exercise slows down the disease. It keeps people better longer. It keeps them active longer, muscular-wise, they do better. Walking and balance-wise, they do better. Sleep-wise, they do better. Mood-wise, they do better. Exercise really is the best medicine for Parkinson’s disease at this point.”
That advice has led to the development of all sorts of exercise and movement classes that can help manage symptoms and improve quality of life. Some of the options developed specifically for Parkinson’s patients include a type of boxing class to improve motor skills, Tai chi classes with flowing movements that can help improve or maintain balance and coordination to reduce the risk of falls. Dance and yoga classes tailored to people with Parkinson’s are also a good option to focus on coordination, flexibility and movement. Vocal training classes can help to improve communications skills impacted by Parkinson’s and help with vocal projection. Other classes offer a focus on cognitive exercises along with physical activity to help keep mental skills sharp.
To find classes for Parkinson’s patients, visit the Parkinson’s Foundation at www.parkinson.org and the American Parkinson Disease Association at www.apdaparkinson.org.