Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico.
Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos 15067, Peru.
Int J Mol Sci. 2024 Jun 29;25(13):7183. doi: 10.3390/ijms25137183.
Parkinson's disease (PD) is a gradually worsening neurodegenerative disorder affecting the nervous system, marked by a slow progression and varied symptoms. It is the second most common neurodegenerative disease, affecting over six million people in the world. Its multifactorial etiology includes environmental, genomic, and epigenetic factors. Clinical symptoms consist of non-motor and motor symptoms, with motor symptoms being the classic presentation. Therapeutic approaches encompass pharmacological, non-pharmacological, and surgical interventions. Traditional pharmacological treatment consists of administering drugs (MAOIs, DA, and levodopa), while emerging evidence explores the potential of antidiabetic agents for neuroprotection and gene therapy for attenuating parkinsonian symptoms. Non-pharmacological treatments, such as exercise, a calcium-rich diet, and adequate vitamin D supplementation, aim to slow disease progression and prevent complications. For those patients who have medically induced side effects and/or refractory symptoms, surgery is a therapeutic option. Deep brain stimulation is the primary surgical option, associated with motor symptom improvement. Levodopa/carbidopa intestinal gel infusion through percutaneous endoscopic gastrojejunostomy and a portable infusion pump succeeded in reducing "off" time, where non-motor and motor symptoms occur, and increasing "on" time. This article aims to address the general aspects of PD and to provide a comparative comprehensive review of the conventional and the latest therapeutic advancements and emerging treatments for PD. Nevertheless, further studies are required to optimize treatment and provide suitable alternatives.
帕金森病（PD）是一种逐渐恶化的神经退行性疾病，影响神经系统，其特点是缓慢进展和症状多样。它是第二常见的神经退行性疾病，影响全球超过 600 万人。其多因素病因包括环境、基因组和表观遗传因素。临床症状包括非运动症状和运动症状，运动症状是经典表现。治疗方法包括药物治疗、非药物治疗和手术干预。传统的药物治疗包括给予药物（MAOIs、DA 和左旋多巴），而新兴证据则探讨了抗糖尿病药物的神经保护作用和基因治疗减轻帕金森症状的潜力。非药物治疗，如运动、富含钙的饮食和充足的维生素 D 补充，旨在减缓疾病进展和预防并发症。对于那些有药物诱导的副作用和/或难治性症状的患者，手术是一种治疗选择。深部脑刺激是主要的手术选择，与运动症状改善相关。通过经皮内镜胃空肠造口术和便携式输注泵给予左旋多巴/卡比多巴肠内凝胶输注，成功减少了“关”期（即出现非运动和运动症状的时间），增加了“开”期（即运动症状改善的时间）。本文旨在讨论 PD 的一般方面，并对 PD 的常规和最新治疗进展以及新兴治疗方法进行全面比较综述。然而，需要进一步的研究来优化治疗方法并提供合适的替代方案。
