Abstract:
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.
摘要:
帕金森病(PD)是一种逐渐恶化的影响神经系统的神经退行性疾病,以缓慢的进展和不同的症状为标志。它是第二常见的神经退行性疾病,影响了世界上600多万人。它的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和运动症状,运动症状是经典的表现。治疗方法包括药理学,非药理学,和手术干预。传统的药物治疗包括给药(MAOIs,DA,和左旋多巴),而新出现的证据探讨了抗糖尿病药物用于神经保护和基因治疗以减轻帕金森病症状的潜力。非药物治疗,比如锻炼,富含钙的饮食,补充足够的维生素D,旨在减缓疾病进展和预防并发症。对于那些有药物引起的副作用和/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,与运动症状改善有关。通过经皮内镜胃空肠造口术和便携式输液泵输注左旋多巴/卡比多巴肠凝胶成功地减少了“关闭”时间,出现非运动和运动症状的地方,增加“开启”时间。本文旨在解决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比较全面的综述。然而,需要进一步的研究来优化治疗并提供合适的替代方案。