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早期帕金森病的治疗

Treatment of early Parkinson's disease.

作者信息

Pahwa Rajesh, Lyons Kelly E

机构信息

A National Parkinson Foundation Center of Excellence, University of Kansas Medical Center, Kansas City, Kansas, USA.

出版信息

Curr Opin Neurol. 2014 Aug;27(4):442-9. doi: 10.1097/WCO.0000000000000113.

Abstract

PURPOSE OF REVIEW

This review summarizes currently available treatment options and treatment strategies, investigational treatments, and the importance of exercise for early Parkinson's disease.

RECENT FINDINGS

The available treatment options for early Parkinson's disease have changed little in the past decade and include carbidopa/levodopa, dopamine agonists, and monoamine oxidase type B (MAO-B) inhibitors. However, we discuss changes in treatment strategies, including dosing and the use of combination therapy used in an attempt to reduce or delay the appearance of motor complications and other adverse events. We will also review several investigational treatments that have shown promise for the treatment of early Parkinson's disease, including a new extended release formulation of carbidopa/levodopa (IPX066), safinamide which inhibits MAO-B, dopamine uptake and glutamate and pardoprunox which is a 5HT-1A agonist and a partial dopamine agonist. Finally, we discuss recent studies focusing on exercise as an important component in the management of early Parkinson's disease.

SUMMARY

Advances in the management of early Parkinson's disease include evolving treatment strategies, new investigational treatments, and earlier implementation of various forms of exercise.

摘要

综述目的

本综述总结了目前早期帕金森病可用的治疗选择和治疗策略、研究性治疗方法以及运动锻炼的重要性。

最新研究发现

在过去十年中,早期帕金森病的可用治疗选择变化不大,包括卡比多巴/左旋多巴、多巴胺激动剂和单胺氧化酶B型(MAO - B)抑制剂。然而,我们讨论了治疗策略的变化,包括剂量调整以及联合治疗的应用,旨在减少或延迟运动并发症和其他不良事件的出现。我们还将综述几种对早期帕金森病治疗显示出前景的研究性治疗方法,包括卡比多巴/左旋多巴的新型缓释制剂(IPX066)、抑制MAO - B、多巴胺摄取以及谷氨酸的沙芬酰胺,还有作为5 - HT - 1A激动剂和部分多巴胺激动剂的帕罗西汀。最后,我们讨论了近期将运动锻炼作为早期帕金森病管理重要组成部分的研究。

总结

早期帕金森病管理方面的进展包括不断演变的治疗策略、新的研究性治疗方法以及更早地实施各种形式的运动锻炼。

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