Transcript Recent developments in treatment of PD

Recent developments in
treatment of PD
Drug treatments
L-DOPA still the mainstay
Other dopamine agonists may prevent
side effects
Lesion methods
Lesions to subthalamic nucleus can
control tremor
Deep brain stimulation
Pacemaker like device implanted in
subthalamic nucleus
Reversible lesion
Implants of fetal cells
1st double-blind placebo-controlled surgical
trial reported in 2001 (Freed, NEJM).
40 patients, 20 received implants and 20
had placebo procedure
PET images showed implants grew
Little evidence for improvement after 1
year
15% had dyskinesia that could not be
controlled by drugs
Whatever happened to J. William
Langston?
Director of Parkinson’s Institute in Sunnyvale CA.
Still studying effects of environmental toxins on PD
New findings suggest tobacco and caffeine exert protective effect
Whatever happened to the MPTP
model?
150-200 new research reports/year
Still the single most important model of PD
A few mouse models now exist
MPTP model is still most valuable way to
test new drugs

Eg continuous vs. pulsatile delivery and sideeffects (Jenner)