[Problems and future perspectives in the treatment of Parkinson's disease]

The most prominent neuropathological lesions in Parkinson's disease have been found in the substantia nigra. The neurochemical alterations are numerous; the most prominent one is the imbalance between acetylcholine and dopamine, the latter transmitter being deficient. Up to now the striato-nigral dopaminergic receptor is the best investigated and the most useful target for an effective therapy. However, a more specific modulation, stimulation or blockade of these receptors, could strongly reduce the occurrence of the side-effects and the drug resistance that are to be seen after a dopamine substitution started too early or too vigorously.