2017 年 33 巻 4 号 p. 518-521
We review reports published in 2015 providing new information on management of Parkinson's disease (PD) and related disorders.
We report here the outcome of this new medical management of PD. Coenzyme Q10 improved motor symptoms in PD patients with wearing–off phenomenon. Pioglitazone, which is shown to have a neuroprotective effect in pre–clinical study, and neurturin, a neurotrophic factor, did not show symptom relieve nor inhibit the disease progression. Multidisciplinary rehabilitation, multi–dimensional balance programme and repetitive transcranial magnetic stimulation improved balance, gait performance and motor function. For treatment of motor fluctuation, ADS–5102, an amantadine extended release capsule, and eltoprazine, a 5–HT1A/B agonist, reduced levodopa–induced dyskinesia. Opicapone, a catechol–O–methyltransferase inhibitor, reduced off time.
In studies aimed at improvement of non–motor functions in PD, transcutaneous tibial nerve stimulation reduced lower urinary tract symptoms such as urgency and nocturia. Droxidopa improved orthostatic hypotension, but efficacy lasted only one week. Injection of botulinum toxin type A into the parotid glands was effective in reducing drooling. Patients with chronic pain reported significant relief with prolonged release, oral formulation oxycodone combined with naloxone. Meta–analysis for treatment of cognitive impairment in PD showed cholinesterase inhibitors, aside from memantine, were effective. Exercise training such as modified Fitness Counts (mFC) and Progressive Resistance Exercise Training (PRET) improved attention and working memory.
For treatment of parkinsonian type multiple system atrophy, rasagiline ― shown to have neuroprotective effects in preclinical studies ― did not show clinical effectiveness for multiple system atrophy.
