July 2011
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.
