Pletscher A, DaPrada M
Swiss Academy of Medical Sciences, Basel.
Acta Neurol Scand Suppl. 1993;146:26-31.
The last decades have been characterized by impressive research activity in connection with Parkinson's disease (PD). A wealth of new results have enriched our knowledge of the pathophysiology of the disorder and led to new approaches for its therapy. Whereas anticholinergic drugs remained the main, though unsatisfactory, treatment of PD for almost 100 years, the situation has changed since the 1960s. An impetus for this turning-point was given by the finding that the striatum of rats contained a high concentration of dopamine (DA) which until then had been considered to be a mere intermediate of the biosynthesis of noradrenaline and adrenaline, without a physiological role in its own right. Subsequently, the role of dopamine as neurotransmitter and the importance of dopaminergic pathways for the control of extrapyramidal motricity were firmly established. As a consequence, new therapeutic possibilities emerged and the anticholinergic drugs, although still in use, lost their supremacy. The present minireview will be restricted to new treatments which have been developed and introduced since 1960 and to recent pharmacotherapeutic approaches with potential future usefulness.
过去几十年，帕金森病（PD）相关的研究活动十分活跃。大量新成果丰富了我们对该疾病病理生理学的认识，并带来了新的治疗方法。尽管近100年来抗胆碱能药物一直是PD的主要治疗手段，但效果并不理想。自20世纪60年代以来，情况发生了变化。这一转折点的推动力来自一项发现，即大鼠纹状体中含有高浓度的多巴胺（DA），在此之前，多巴胺一直被认为只是去甲肾上腺素和肾上腺素生物合成的中间产物，自身并无生理作用。随后，多巴胺作为神经递质的作用以及多巴胺能通路对锥体外系运动控制的重要性得以确立。结果，新的治疗可能性出现了，抗胆碱能药物尽管仍在使用，但已失去了主导地位。本综述将仅限于自1960年以来开发和引入的新治疗方法以及具有潜在未来应用价值的近期药物治疗方法。
