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Review Article

IJMDC. 2021; 5(5): 1248-1256


The rationale of treatment strategies in Parkinson's disease in relation to motor and cognitive dysfunctions: a review

Enas Kassem, Noha Yahya Barradah.




Abstract

Parkinson's disease (PD) is the second most common age-related neurodegenerative disease worldwide. It is one of the most common disabling diseases with many motor and cognitive dysfunctions causing dependency and poor quality of life making efficient treatment mandatory. The aim of this review is to highlight the prevalence of PD worldwide and in the Middle East, understand its pathophysiological mechanism, and discuss and evaluate the main lines of treatment for PD and their targets in treating the motor and cognitive dysfunctions. Motor dysfunctions were mainly due to dopaminergic alterations in the basal ganglia (BG). They were usually presented as bradykinesia, rigidity, tremors, and postural instability. Dementia is the most common cognitive dysfunction in the disease. The main goal of treatment was to treat the dopaminergic dysfunction with a variety of pharmacological methods, including dopamine (DA) precursors, such as levodopa, DA agonists, and monoamine oxidase inhibitors. There were other lines of treatment, such as deep brain stimulation (DBS), stem cell transplantation, and gene therapy. In this review, it was found that the DA precursor, levodopa, is considered the standard therapy for PD. However, it is better to delay the usage of it, especially in young age. DBS and cell transplantation could be promising treatments in the future as they need further exploration. Physiotherapy and rehabilitation shows significant effects in improving the quality of life.

Key words: Parkinson's disease, dopamine, basal ganglia, motor dysfunctions, and cognitive dysfunctions.






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