Interesting; this was published in 2011.
Priorities in Parkinson's disease research
Quote: Key Points
Despite recent advances in the treatment of Parkinson's disease (PD), dyskinesia and motor fluctuations still make a substantial contribution to the reduced quality of life of patients with advanced-stage PD. Additionally, non-motor signs such as depression, dementia, sleep abnormalities and autonomic failure are increasingly being recognized as challenges to effective treatment as they dominate the clinical, caregiver and financial burden of the later stages of PD.
The translational value of current preclinical models of neurodegeneration remains unsatisfactory. Current limitations could be overcome in a number of ways; for example, by obtaining combinations of mutations by breeding mice with single or dual mutations, or by challenging existing models with environmental stressors such as neurotoxins or neuroinflammation inducers in animals with an established and stable background.
Novel drug targets will be uncovered through pathophysiological insights gained from the identification of the role of genetic mutations that are responsible for hereditary forms of PD, and future therapies targeted towards these mutations will have broader efficacy against sporadic PD than the currently available symptomatic treatments.
Many of the therapies that are currently under development — both dopaminergic and non-dopaminergic compounds — are focused on improving motor control, fluctuations and dyskinesias. Far fewer approaches address the other two key unmet clinical needs: specifically, alleviating non-motor symptoms, and disease modification and/or neuroprotection.
The most promising strategy to achieve disease modification or neuroprotection seems to be a combination of compounds that interfere simultaneously with different key events of PD pathology. This approach would require collaboration between the pharmaceutical companies that hold the patent rights of the different compounds.
Primary end points in past and ongoing trials of potential disease-modifying or neuroprotective drugs rely on clinical assessment scales. Additional efforts are therefore urgently needed to establish validated biomarkers in PD.