Lindvall S, Plaitakis A
Parkinson’s disease (PD) was the first neurodegenerative disease in which a neurotransmitter replacement therapy was proven effective. That agent, levodopa, which replaces the deficiency in dopamine, is still the gold standard treatment more than 40 years after its introduction. While management has advanced since the 1960s with the use of alternative symptomatic treatments, adjunctive agents, electric brain stimulation approaches and new methods of drug delivery, no treatment is currently known that is capable of arresting the progressive nature of the disease.
As PD progresses, affected patients often experience a multitude of symptoms related to both the motor and non-motor manifestations of the disorder. Successful management of these manifestations requires knowledge of their pathophysiology and skilful application of available treatment modalities. While these developments have helped improve the quality of life (QoL) of people living with PD, many patients still experience disabling symptoms related to the disease itself and/or to complications of chronic administration of anti-parkinsonian drugs. Hence, there is still a need to have a better understanding of the disease processes, the factors that are important to a patient’s QoL and to develop new therapeutic approaches.
There is also a basic need for better access to the full range of PD treatments. Many patients feel powerless to access the appropriate resources, and those that do gain access often expend a great deal of energy in doing so and require a great deal of knowledge of the disease. Several recent initiatives, however, have sought to improve this situation, such as ParkinsonNet in The Netherlands (www.parkinsonnet.nl/welcome.aspx), which provides information to patients that allows them to contribute to healthcare decisions, gives access to experts and builds an online network of patients.
The European Parkinson’s Disease Association (www.epda.eu.com) has been an important development in the campaign to improve access to PD treatments. The aim of EPDA is to improve the potential of patients with PD to lead full lives, support the search for a cure and spearhead important initiatives for raising awareness and stimulating better communication.