Kim Hee J, Jeon Beom S, Jenner Peter
Konkuk University School of Medicine, Seoul, South Korea; Parkinson Disease Study Group, Seoul National University Hospital, Seoul, South Korea.
Parkinson Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Movement Disorder Center, Neuroscience Research Institute, College of Medicine, Seoul National University, Seoul, South Korea.
Int Rev Neurobiol. 2017;132:295-343. doi: 10.1016/bs.irn.2017.01.006. Epub 2017 Mar 20.
Deficit of striatal dopamine was first discovered in postmortem brain of patients with Parkinson's disease in 1960. This observation was the starting point for dopamine replacement therapy, and successful introduction of high dose l-dopa therapy in the 1969 revolutionized the treatment of Parkinson's disease. Since then, constant attempts have been made to enhance the efficacy of l-dopa and reduce motor complications by providing more continuous dopamine stimulation. This chapter traces the hallmarks of medical treatments for Parkinson's disease throughout centuries including the first description of antiparkinsonian effects of anticholinergics, the birth of apomorphine in the 1900s, then discovery of l-dopa in the 1960s, and development of dopamine agonists since the 1970s.
1960年,纹状体多巴胺缺乏首次在帕金森病患者的尸检大脑中被发现。这一观察结果是多巴胺替代疗法的起点,1969年高剂量左旋多巴疗法的成功引入彻底改变了帕金森病的治疗方式。从那时起,人们不断尝试通过提供更持续的多巴胺刺激来提高左旋多巴的疗效并减少运动并发症。本章追溯了几个世纪以来帕金森病医学治疗的标志性进展,包括抗胆碱能药物抗帕金森病作用的首次描述、20世纪初阿扑吗啡的诞生、20世纪60年代左旋多巴的发现以及20世纪70年代以来多巴胺激动剂的发展。