Treatments for Parkinson's Disease
Conventional Western Treatment
At present, there is no cure for Parkinson's disease. But a variety of medications and therapies provide dramatic relief from the symptoms. There are two types of Parkinson's disease treatments, pharmacologic and surgical. Drugs remain, by far, the most common choice, but surgery, particularly pallidotomy and thalamotomy, has become increasingly popular in the past several years. Novel experimental procedures are being studied.
Usually, drug therapy will be tried first. Surgical interventions are performed only if the person does not respond to medications or the doctor feels that the quality of life can be improved substantially by non-drug interventions, such as when the symptoms get worse despite trying all available medicines.
Today, levodopa therapy remains the gold standard of symptomatic treatment for Parkinson's disease. However, long-term therapy with levodopa is less than satisfactory as disability continues to progress and most patients develop levodopa-associated motor fluctuations and dyskinesia within a few years of treatment. Many patients ultimately develop disability due to difficulty with balance and cognition. For this reason, much research in Parkinson's disease today focuses on how to forestall disability and maintain or improve function over the long-term. New combination druga and surgical procedures available.
There is considerable differences of opinion concerning whether the patient should be started immediately on drugs or wait till the disease has progressed. As noted, levodopa loses effectiveness and develops long term complications after 4-5 years. So, the doctors do not want to lose the window of opportunity. (Some prefer starting early on levodopa therapy at a lower dose and increasing the dosage as needed. Some doctors keep levodopa at very low levels by using other medicines in combination. Still others delay levodopa therapy as much as possible by using alternative drugs.) Newer drugs are available that provide earlier protection before levodopa therapy. The consensus is that a patient should see a doctor at the first opportunity if he/she suspects Parkinson's disease as early interventions are very beneficial.
The basic categories of therapies used to treat Parkinson's disease
Parkinson's Disease Treatments can be divided into three categories:
Symptomatic therapies: These therapies improve signs and symptoms without affecting the underlying disease state. Degeneration of the substantia nigra in Parkinson's disease causes a dopamine deficiency in the striatum.
Neuroprotective therapies: These therapies slow neuronal degeneration, thereby delaying disease progression. An example is selegiline, a monoamine oxidase-B (MAO-B) inhibitor. Selegiline inhibits the oxidative metabolism of levodopa and may reduce oxidative stress and free radical formation.
Restorative therapies: These therapies aim to replace lost neurons. One approach to replacing lost neurons is the transplantation of embryonic tissue. Transplanted embryonic tissue may survive, restore neuronal connections, increase dopamine concentration and improve function. Genetically engineered cells, animal dopaminergic cells, and cells from other parts of the human body are being developed for transplantation and may also have restorative effects.
There are a number of innovative surgical treatments for Parkinson's Disease.
Thalamotomy was widely used in the treatment of Parkinson's
disease about 30 years ago. The procedure, however, quickly fell out of favor after
levodopa therapy was introduced. In the past few years, however, interest has been
renewed in surgical interventions for Parkinson's disease because existing techniques have
been refined and shown to benefit many patients who are not responding adequately to drug
therapy. Thalamotomy and thalamic stimulation are effective for ameliorating medically
refractory tremor. Pallidotomy and pallidal stimulation alleviate dyskinesias. Stimulation
of the subthalamic nucleus holds great promise for smoothing motor fluctuations, lessening
dyskinesias, and improving signs of Parkinson's disease. Two of the better-known
experimental procedures are the transplantation of neural tissue into the brain, which has
produced some promising results, and deep brain stimulation.
During thalamotomy a stereotactic lesion is created in the
thalamus. Thalamotomy is performed only when the patients do not respond to drug therapy.
The candidates for the procedure are typically younger than 70 and must be free from
Pallidotomy has been found effective in improving rigidity,
bradykinesia, and dyskinesia. It is less useful for correcting gait disturbance, tremor,
and falling. The patients who tend to benefit most from the pallidotomy procedure are
younger than 70 and suffering from disabling dyskinesia despite a generally good response
to levodopa. The procedure is not typically performed in patients with dementia.
Deep Brain Stimulation
-- Researchers are examining naturally occurring enzymes that appear to deactivate
Neural tissue transplants
-- Researchers are studying ways to implant neural tissues from fetal pigs into the brain
to restore the
-- Scientists are modifying the genetic code of individual cells to create
dopamine-producing cells from other
Parkinson's disease results from the brain's inability to produce adequate levels of dopamine, a neurotransmitter whose production is increased when high-protein foods are consumed. Some researchers have speculated that a lifetime of high-protein, high-fat foods have resulted in the overproduction of dopamine. Production of dopamine becomes weaker with time, until the neurons are unable to produce adequate quantities of the neurotransmitter.
Recent research has shown that people with Parkinson's disease respond better to treatment when placed on a high-carbohydrate, low-protein diet. Such a diet is composed chiefly of whole grains, fresh vegetables, beans, and fruit, along with occasional low-fat animal foods, such as fish. Such a diet provides an abundance of vitamins, minerals, trace elements, essential fatty acids, and protein.
Eat a diet that maximizes oxygen and glucose to the brain, one that is extremely low in fat and rich in complex carbohydrates, vitamins, and minerals. Brain function declines when oxygen levels fall due to a high-fat diet. The same is true when glucose levels fall. Blood sugar is increased on a diet rich in complex carbohydrates (found in whole grains, vegetables, and fruit), which are the basis for optimal blood sugar levels. Brain levels of both oxygen and blood sugar are also enhanced when a person gets regular exercise, even a daily walk. Other excellent exercises include yoga and gentle stretching.
The first line of treatment for Parkinson's disease is definitely should be based on Western Medicine. The natural alternatives should be used for synergistic improvements. Holistic Medicine has great potential when used in this way.
Although great advances have been made in treatment of symptoms, the causes and methods of prevention and cure of Parkinson's disease remain essentially unknown.However, research is steadily progressing, and should produce answers to these most critical questions.
There are many practical problems faced by people with
Parkinson's disease as well as their family. They can get valuable information and support
from the many Parkinson's disease support groups that exisit worldwide.
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