Parkinson's disease therapy: tailoring choices for early and late disease, young and old patients.
Identifieur interne : 002196 ( Main/Merge ); précédent : 002195; suivant : 002197Parkinson's disease therapy: tailoring choices for early and late disease, young and old patients.
Auteurs : Joseph Jankovic [États-Unis]Source :
- Clinical neuropharmacology [ 0362-5664 ]
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Cholinergic Antagonists, Dopamine Agonists, Enzyme Inhibitors, Levodopa, Selegiline.
- chemical : Catechol O-Methyltransferase Inhibitors.
- drug therapy : Parkinson Disease.
- surgery : Parkinson Disease.
- Humans.
Abstract
Advances in the understanding of basal ganglia circuitry and its altered function in disease states such as Parkinson's disease (PD), coupled with new insights into the mechanisms of cell death and new findings from therapeutic clinical trials, are being translated into clinical practice. Although levodopa (L-Dopa) remains the most effective drug in the symptomatic treatment of PD, the emergence of side effects, particularly motor fluctuations and dyskinesias, limits its usefulness. Therefore, many parkinsonologists now advocate therapeutic strategies designed to delay the onset of L-Dopa therapy to delay the onset of L-Dopa-related motor complications. The therapeutic approach to PD, however, must be individualized and based on factors such as age of the patient, stage of the disease, and degree of interference of the symptoms with social and occupational functioning, associated symptoms such as cognitive impairment, and response to treatment. This review summarizes the current therapeutic strategies, but it is important to emphasize that the treatment recommendations must be tailored to the needs of individual patients.
PubMed: 11154092
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pubmed:11154092Le document en format XML
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">Joseph Jankovic</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation>
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<wicri:regionArea>Department of Neurology, Baylor College of Medicine, Houston, Texas</wicri:regionArea>
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<region type="state">Texas</region>
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">Joseph Jankovic</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation>
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<wicri:regionArea>Department of Neurology, Baylor College of Medicine, Houston, Texas</wicri:regionArea>
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<term>Dopamine Agonists (therapeutic use)</term>
<term>Enzyme Inhibitors (therapeutic use)</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (surgery)</term>
<term>Selegiline (therapeutic use)</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Cholinergic Antagonists</term>
<term>Dopamine Agonists</term>
<term>Enzyme Inhibitors</term>
<term>Levodopa</term>
<term>Selegiline</term>
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<front><div type="abstract" xml:lang="en">Advances in the understanding of basal ganglia circuitry and its altered function in disease states such as Parkinson's disease (PD), coupled with new insights into the mechanisms of cell death and new findings from therapeutic clinical trials, are being translated into clinical practice. Although levodopa (L-Dopa) remains the most effective drug in the symptomatic treatment of PD, the emergence of side effects, particularly motor fluctuations and dyskinesias, limits its usefulness. Therefore, many parkinsonologists now advocate therapeutic strategies designed to delay the onset of L-Dopa therapy to delay the onset of L-Dopa-related motor complications. The therapeutic approach to PD, however, must be individualized and based on factors such as age of the patient, stage of the disease, and degree of interference of the symptoms with social and occupational functioning, associated symptoms such as cognitive impairment, and response to treatment. This review summarizes the current therapeutic strategies, but it is important to emphasize that the treatment recommendations must be tailored to the needs of individual patients.</div>
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