Avoiding falls with Parkinson’s disease
This article discusses the effects of Parkinson’s on balance and offers practical advice on how to avoid falls and maintain mobility.
One Day in Parkinsons Life
Overview of current advances in Parkinson’s therapy, from drug innovations and deep brain stimulation to gene therapy and biomarker development.
Parkinson’s disease is one of the fastest growing neurodegenerative diseases in the world. Although there is still no cure, significant progress has been made in research and treatment in recent years. From new drug approaches to innovative technologies such as deep brain stimulation (DBS) and gene therapies, modern medicine is continuously working to improve the quality of life for people with Parkinson’s.
In this article, we take a look at the latest advances in Parkinson’s research and highlight new treatment approaches that offer hope for the future.
Levodopa remains the most effective drug for treating Parkinson’s symptoms, particularly motor symptoms such as tremors, rigidity and slowed movements. Since its introduction in the 1960s, levodopa has improved the lives of millions of people with Parkinson’s disease. However, the drug loses its effectiveness in many patients after several years, and side effects such as dyskinesia (involuntary movements) often occur.
In recent years, new formulations of levodopa have been developed to prolong efficacy and minimise side effects. One example is levodopa-carbidopa intestinal gel (LCIG), a form of levodopa that is delivered directly into the small intestine to ensure a more consistent release of the drug. This continuous release of the medication helps to reduce the “off-phases” – periods of time when the medication is no longer effective.
An acquaintance who has been taking levodopa for many years told me that the introduction of the LCIG gel has brought a significant improvement for him. Previously, he often had problems with sudden “off phases” during which his movements were severely restricted. Since switching to the gel, these phases have become less frequent and he can manage his everyday life better.
In addition to levodopa, dopamine agonists also play an important role in the treatment of Parkinson’s disease. These drugs mimic the effect of dopamine in the brain and help to alleviate the symptoms. In recent years, new dopamine agonists have been developed that last longer and have fewer side effects.
In addition, research is being conducted into new classes of drugs that influence dopamine levels in the brain in other ways. One promising approach is the inhibition of MAO-B (monoamine oxidase B), an enzyme that breaks down dopamine. MAO-B inhibitors such as rasagiline and selegiline help to increase dopamine levels and alleviate symptoms.
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h3>What is deep brain stimulation?
Deep brain stimulation (DBS) is an advanced treatment method in which electrodes are implanted in specific areas of the brain to send electrical impulses that regulate the abnormal activity caused by Parkinson’s disease. DBS is usually used in patients for whom drug therapy is no longer sufficiently effective or causes severe side effects.
Since its introduction in the 1990s, DBS has continued to evolve. New technologies enable doctors to adapt the stimulation even more precisely, leading to better treatment results and fewer side effects.
Advanced DBS systems now offer advanced customisation options that allow stimulation parameters to be adjusted in real time. Patients can control their own stimulation settings via wearable devices, giving them more control over their symptoms. This is particularly helpful in managing “on-off” fluctuations that are common in advanced Parkinson’s disease.
Current research projects are investigating how DBS can be extended to other brain regions to treat non-motor symptoms such as depression, anxiety and cognitive impairment. It is expected that DBS can be used more widely in the future to address more aspects of Parkinson’s disease.
I have met patients who have significantly improved their quality of life thanks to DBS. One acquaintance, who suffered from severe motor symptoms, told me that DBS had given him back the feeling of regaining control over his body. He found it particularly remarkable that he is now less dependent on medication and feels more stability in his everyday life.
Although most cases of Parkinson’s occur sporadically, there are genetic variants of the disease that are due to mutations in certain genes such as SNCA, LRRK2 and PARK2. These genetic findings have paved the way for new therapeutic methods such as gene therapy.
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In gene therapy, defective genes are repaired or replaced in order to treat the underlying causes of the disease. One promising therapy involves introducing a functional gene into the brain that helps to protect or even regenerate the dopamine-producing cells.
One of the most promising approaches in gene therapy is the use of viral vectors that transport the healthy gene into the affected cells. This approach is currently being investigated in clinical trials and the initial results are encouraging. In the future, gene therapy could offer a long-term solution for the treatment of Parkinson’s disease, especially for younger patients with genetic mutations.
In a recent clinical trial, a gene therapy was tested that uses the GDNF gene (glial cell line-derived neurotrophic factor). This gene codes for a protein that supports the survival of dopamine-producing neurons. The results of the study showed that the gene therapy was able to slow down the progression of the disease and improve motor symptoms.
In conversations with people who have participated in gene therapy clinical trials, I felt great hope. One participant told me that he felt less tremors and more energy after the treatment. Although the therapy is still in development, it seems to have the potential to become a revolutionary treatment method in the future.
One of the biggest challenges with Parkinson’s is the late diagnosis. As a rule, the disease is only recognised when 60-80% of the dopamine-producing cells in the brain have already been destroyed. Research is therefore increasingly focussing on early detection in order to be able to influence the course of the disease at an earlier stage.
Biomarkers are measurable indicators that point to the presence or progression of a disease. Various biomarkers are currently being investigated for Parkinson’s that could help diagnose the disease at an earlier stage. These include:
I have heard from patients who already had significant motor symptoms when they were diagnosed, and they often expressed regret that the disease was not recognised earlier. Many wish they had been diagnosed earlier so that treatment could be started sooner. The development of biomarkers could make a big difference here in the future and enable patients to receive effective treatment at an early stage.
Research in the field of Parkinson’s therapy has made considerable progress in recent years. From improved medications and modern technologies such as deep brain stimulation to promising approaches in gene therapy – the treatment options for people with Parkinson’s are constantly evolving. Early detection using biomarkers could enable even earlier diagnosis in the near future, paving the way for even more effective treatments.
Although a cure is not yet in sight, these advances offer hope to those affected and significantly improve their quality of life. It remains exciting to see how Parkinson’s therapy will develop in the coming years.
This article discusses the effects of Parkinson’s on balance and offers practical advice on how to avoid falls and maintain mobility.
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