[Parkinson's Disease - What is New?]

Area of Science:

• Neurology
• Geriatrics
• Pharmacology

Background:

• Parkinson's disease (PD) prevalence is projected to double by 2030, with increasing recognition of its diverse forms.
• The COVID-19 pandemic highlighted challenges in PD patient care, accelerating the adoption of teleconsultations for remote neurological assessments.
• Ongoing debates surround the optimal timing for initiating levodopa therapy in PD management.

Purpose of the Study:

• To review current therapeutic strategies and emerging treatments for Parkinson's disease.
• To address the controversy regarding early levodopa initiation.
• To discuss advancements in managing motor fluctuations and non-motor symptoms in PD.

Main Methods:

• Literature review of recent studies on Parkinson's disease treatments.
• Analysis of the evolving role of dopamine agonists and new pharmacological agents.
• Evaluation of the efficacy of deep brain stimulation, drug pumps, physiotherapy, and multidisciplinary care.

Main Results:

• Early initiation of levodopa is advised, dispelling fears of accelerating disease progression.
• Dopamine agonists are associated with significant side effects, including impulse control disorders.
• Newer drugs like safinamide and opicapone offer add-on therapy for levodopa-induced fluctuations.
• Invasive therapies (deep brain stimulation, drug pumps) and physiotherapy show promise for advanced PD stages.
• Multidisciplinary networks effectively reduce falls and hospitalizations.

Conclusions:

• Physicians should not delay levodopa treatment in early Parkinson's disease.
• Careful consideration of dopamine agonist side effects is necessary.
• Advanced therapies and supportive care, including physiotherapy and multidisciplinary networks, are crucial for optimizing outcomes in advanced PD.