Parkinson Hastalığı Tedavisinde Yeni Geliştirilen Medikal ve Cerrahi Tedavi Seçenekleri
Özet
Parkinson hastalığının tedavisindeki güncel medikal ve cerrahi stratejilerin incelendiği bu çalışmada, standart levodopa tedavisine yanıt vermeyen ileri evre hastalar için geliştirilen levodopa/karbidopa intestinal jel ve derin beyin stimülasyonu gibi yöntemler detaylandırılmaktadır. Ayrıca fiziksel egzersizin semptomlar üzerindeki olumlu etkileri ile alfa-sinükleini hedefleyen immünoterapiler, gen tedavileri ve bağırsak mikrobiyotası odaklı yaklaşımlar gibi faz aşamasındaki yenilikçi tedavi seçenekleri sunulmaktadır. Makale, hastalığın etyolojisine yönelik kişiselleştirilmiş stratejilerin ve nöroprotektif yaklaşımların gelecekteki tedavi başarısı için taşıdığı kritik önemi vurgulayarak sonuçlanmaktadır.
This study examines current medical and surgical strategies in the treatment of Parkinson's Disease, detailing methods such as levodopa/carbidopa intestinal gel and deep brain stimulation for advanced-stage patients who no longer respond to standard therapies. It also presents the positive effects of physical exercise on symptoms alongside innovative phase-stage treatment options, including alpha-synuclein-targeted immunotherapies, gene therapies, and gut microbiota-focused approaches. The article concludes by emphasizing the critical importance of personalized, etiology-targeted strategies and neuroprotective approaches for the future success of Parkinson's treatment.
Referanslar
Armstrong MJ, Okun MS. Diagnosis and treatment of Parkinson disease: a review. Jama. 2020;323(6):548-60.
Adiguzel A, Ozturk U, Altinayar S. Parkinson's Disease Profile–A 17-Year Patient Analysis. Dicle Tıp Dergisi. 2020;47(3):508-16.
Reich SG, Savitt JM. Parkinson's Disease. Med Clin North Am. 2019;103(2):337-50.
Kulisevsky J, Oliveira L, Fox SH. Update in therapeutic strategies for Parkinson's disease. Current opinion in neurology. 2018;31(4):439-47.
Seeberger LC, Hauser RA. Carbidopa levodopa enteral suspension. Expert Opin Pharmacother. 2015;16(18):2807-17.
Cury RG, Fraix V, Castrioto A, Fernández MAP, Krack P, Chabardes S, et al. Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia. Neurology. 2017;89(13):1416-23.
Almeida L, Deeb W, Spears C, Opri E, Molina R, Martinez-Ramirez D, et al., editors. Current practice and the future of deep brain stimulation therapy in Parkinson's disease. Seminars in neurology; 2017: Thieme Medical Publishers.
Bond AE, Shah BB, Huss DS, Dallapiazza RF, Warren A, Harrison MB, et al. Safety and efficacy of focused ultrasound thalamotomy for patients with medication-refractory, tremor-dominant Parkinson disease: a randomized clinical trial. JAMA neurology. 2017;74(12):1412-8.
Martínez-Fernández R, Rodríguez-Rojas R, Del Álamo M, Hernández-Fernández F, Pineda-Pardo JA, Dileone M, et al. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study. The Lancet Neurology. 2018;17(1):54-63.
Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, et al. Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: a phase 2 randomized clinical trial. JAMA neurology. 2018;75(2):219-26.
Song R, Grabowska W, Park M, Osypiuk K, Vergara-Diaz G, Bonato P, et al. The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: a systematic review and meta-analysis. Parkinsonism & related disorders. 2017;41:3-13.
Collett J, Franssen M, Meaney A, Wade D, Izadi H, Tims M, et al. Phase II randomised controlled trial of a 6-month self-managed community exercise programme for people with Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry. 2017;88(3):204-11.
Tarakad A, Jankovic J. Recent advances in understanding and treatment of Parkinson’s disease. Faculty Reviews. 2020;9.
Wang Z, Gao G, Duan C, Yang H. Progress of immunotherapy of anti-α-synuclein in Parkinson’s disease. Biomedicine & Pharmacotherapy. 2019;115:108843.
Masliah E, Rockenstein E, Adame A, Alford M, Crews L, Hashimoto M, et al. Effects of α-synuclein immunization in a mouse model of Parkinson’s disease. Neuron. 2005;46(6):857-68.
Horvath I, Iashchishyn IA, Forsgren L, Morozova-Roche LA. Immunochemical detection of α-synuclein autoantibodies in Parkinson’s disease: correlation between plasma and cerebrospinal fluid levels. ACS chemical neuroscience. 2017;8(6):1170-6.
Jankovic J, Tan EK. Parkinson’s disease: etiopathogenesis and treatment. Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(8):795-808.
Simuni T, Fiske B, Merchant K, Coffey CS, Klingner E, Caspell-Garcia C, et al. Efficacy of nilotinib in patients with moderately advanced Parkinson disease: a randomized clinical trial. JAMA neurology. 2021;78(3):312-20.
Qian H, Kang X, Hu J, Zhang D, Liang Z, Meng F, et al. Reversing a model of Parkinson’s disease with in situ converted nigral neurons. Nature. 2020;582(7813):550-6.
Adiguzel A, Altinayar S, Gulbay G, Yesilada E. LRRK2 G2019S, I2020T, R1441C GENE mutation analysis in patients with idiopathic Parkinson’s in Turkey. Medicine. 2020;9(2):459-61.
Tolosa E, Vila M, Klein C, Rascol O. LRRK2 in Parkinson disease: challenges of clinical trials. Nature Reviews Neurology. 2020;16(2):97-107.
Sampson TR, Debelius JW, Thron T, Janssen S, Shastri GG, Ilhan ZE, et al. Gut microbiota regulate motor deficits and neuroinflammation in a model of Parkinson’s disease. Cell. 2016;167(6):1469-80. e12.
Huang H, Xu H, Luo Q, He J, Li M, Chen H, et al. Fecal microbiota transplantation to treat Parkinson's disease with constipation: a case report. Medicine. 2019;98(26).
Jankovic J, Okun MS, Kordower JH. Stem cells: scientific and ethical quandaries of a personalized approach to Parkinson's disease. Movement Disorders. 2020;35(8):1312-4.
