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Parkinson’s Disease And Clinical Trials

The second most prevalent neurodegenerative disorder is Parkinson's disease (PD). Almost 6 million individuals are globally affected by this disease. There are no specific curative treatments available for PD. Symptomatic treatments are available but show limited effects on slowing or halting progression of the disease. It's estimated that in 2040, the incidence of Parkinson's disease may double from what it is today.


Most of the current drug treatments were only approved for clinical use in the second part of the twentieth century and only gave symptomatic relief. However, clinical trials are underway to test prospective disease-modifying therapies that can delay, stop, or reverse the condition. There remains a significant amount of continuing clinical research of symptomatic medicines to improve patients' quality of life with Parkinson's disease.


Current Treatments of Parkinson's Disease

Levodopa was the first FDA-approved drug for PD, and is still considered the mainstay of first-line treatment. In the years since, derivatives and improved reformulations have been developed, as well as non-pharmacological PD treatments such as deep brain stimulation, pallidotomy/sub thalamotomy, and high-intensity focused ultrasound.


Unfortunately, none of these treatment approaches target the disease's underlying causes and offer nothing to slow its progression.


New Options for Parkinson's Disease

In the year 2020, the FDA approved three pharmaceutical options for managing "off" time, the phase when symptoms of PD recur between medication doses. These include a levadopa inhaler, a thin film of apomorphine for oral use like a breath strip, and a catechol-O-methyltransferase inhibitor drug. However, whereas other therapies may enhance PD patients' quality of life, the ultimate objective of stopping and reversing the disease's development remain elusive.


Evidence of Zonisamide for Its use in Parkinson's Disease

The drug zonisamide has long been used to treat epilepsy, but it was discovered by chance to help patients with PD. Following that, numerous trials were planned to evaluate the use of zonisamide in PD. Most of these studies have been conducted in Japan.


There are indications that zonisamide, combined with levodopa and other medications, can help reduce motor symptoms in people with Parkinson's disease. However, the evidence for its use in treating non-motor symptoms in Parkinson's disease is insufficient, and more research is needed.


Use of a Non-Invasive Brainstem Neuromodulation Device in Parkinson's Disease

Several methods of non-invasive brain stimulation have been tested in PD. The principal techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Studies suggest a possible therapeutic potential, but clinical effects so far have been small and insignificant when it comes to independence and quality of life for PD patients.


References
  • https://www.centerwatch.com/clinical-trials/listings/267117/use-of-a-non-invasive-brainstem-neuromodulation-device-to-improve-neurovascular-status-in-parkinsons-disease/?&query=parkinsons-disease&featured=true&rnk=3
  • https://pubmed.ncbi.nlm.nih.gov/24347760/
  • https://pubmed.ncbi.nlm.nih.gov/34151864/
  • https://pubmed.ncbi.nlm.nih.gov/32741777/
  • https://content.iospress.com/articles/neurorehabilitation/nre1237