Treatment and Care of Parkinsons Disease

Parkinsons disease is a disorder of the motor system that can significantly affect and decrease a persons quality of life.  Its symptoms are the trembling of hands, arms, legs or jaw rigidity of the limbs sudden slowness of movement and impaired balance and coordination while moving (Stewart A. Factor  William J. Weiner, 2008, p.47).

The primary cause for Parkinsons disease is the death or impairment of the neurons in the area of the brain known as the substantia nigra.  The neurons in this part of the brain produce a chemical known as dopamine which is responsible for transmitting signals from one part of the brain to the other.

Diagnosing Parkinsons disease is very difficult as there is no blood or laboratory tests that can help detect Parkinsons disease.  Moreover, despite the advances in medical technology, there is no known effective cure for Parkinsons disease.  None of the medications available can halt or retard the death of dopaminergic neuron.  The most that the current medications on Parkinsons disease can do is to treat its symptoms.

Some of the early-stage treatment for Parkinsons involve that treatment with monoamine oxidase-B (MAO-B) inhibitors, amantadine (Symmetrel) or anticholinergics help improve the mild symptoms.  However, these treatments do not slow down cell degeneration and they target only the symptoms.  Moreover, there is a high incidence of adverse affects in the gastro intestine which makes them harmful for use of older patients.

Levodopa is also used as treatment and considered as the most effective pharmacologic agent for Parkinsons disease and remains the primary treatment for symptomatic patients (Shobra Rao, Laura Hofmann and Amer Shakil, 2006, p. 1246).  However, the levodopa does not protect the cells against degeneration or slow it down.  Moreover, it was also found out that after five years of treatment with levodopa 40 of the patients develop motor fluctuations caused by the wearing-off of the effect of levodopa which results in the re-appearance of the symptoms (R. Talati, W. L. Baker, A. A. Patel, K. Reinhart,  C. I. Coleman, 2009, p.616).

The defect in the currently available treatment of Parkinsons disease is that they do not protect the cells or slow down its degeneration.  The treatments only target the diseases symptoms and they only offer end-of-the-pipe approach to Parkinsons disease which is not clinically effective. In contrast, scientists have long believed that the human body can protect itself against cell regeneration just like some of the animals.  For instance, Dr. Jeff S. Mumm, a biologist at the Medical College of Georgia, believes that humans may also have this ability.  He said that With the same general set of genetic tools, these animals can do something we cant regenerate lost cells and tissues. Our job is to figure out which tools in which combination or sequence afford fish this capacity, then apply this knowledge toward the creation of regenerative therapies for humans (Toni Baker, 2008, p.1).

The most recent research on the treatment of Parkinsons disease has been conducted by Ohta, Kuno, Inoue, Ikeda, Fujinami and Ohta (2010).  The research seeks to aid the current studies which are looking for ways on how to effectively treat people with Parkinsons disease.  They seek to find the right treatment by focusing on the substances that can protect the neurons and help in their survival and proper functioning.

According to their research, some dopamine agonists which were applied in cultured cells and animal models have an effect in protecting neurons against cell degeneration (Ohta et al, 2010, p.1).  The research also found that neurotrophic factors, such as the nerve growth factor (NGF) and the glial cell line-derived neurotrophic factor (GDNF), play an important role in the nervous system since they help in slowing down or even preventing the death of the damaged neurons (Ohta et al, 2010, p.1).  They also play a critical role in the maintenance of neuronal function throughout the lifetime of the individual such as regulation of the growth of neurons, cell proliferation and survival.  For instance, GDNF affects motor neurons and selectively protects the nigrostrital dopaminergic pathway.  The protective effect of GDNF on motor neurons is several times greater than those of other known neurotrophic factors.  In rats and monkeys, for instance, GDNF protects dopaminergic neurons of the ventral mesencephalon from cell death.  Moreover, in an experiment involving monkeys, the administration of GDNF for four weeks helped improve dyskinesia, rigidity, and postural instability.  Because of the beneficial effects of the neurotrophic factors in protecting neurons its role in the treatment of Parkinsons disease is being studied further.  

Based on their latest research, dopamine agonists can be used to effectively stimulate neurotrophic factors in the brain (Ohta et al, 2010, p.2).  It must be stressed that the stimulation of the dopamine agonist is essential in the GDNF synthesis and secretion.  The research used the brains of 8-day-old ICR which were excised and cut into pieces for culturing.  The cultured astrocytes were then exposed to four kinds of medicines SKF-38393, apomorphine, bromocriptine, and ropinirole, which is a non-ergoline dopamine agonist, at various concentrations for 24 hour.   The secretion of neurotrophic factors in the cultured astrocytes was then measured by enzyme-linked immunosorbent assay (ELISA).

After the secreted amounts of various neurotrophic factors were measured, it was found that the different medicines resulted in different levels of secretion of neurotrophic factors. Some resulted in maximum secretions while some resulted in minimal secretions.  After measuring the secreted amounts of neurotrophic factors for each of the four medicines, it was found that ropinirole induced the most secretion of neurotrophic factors.

This research establishes that Parkinsons disease is treatable.  With the use of ropinirole, Parkinsons disease may be treated by protecting the neurons against cell degeneration.  At the same time, it can also avoid the side effects commonly associated with the use of the current medications such as nausea and vomiting, drowsiness and sleepiness, dizziness or fainting, hallucinations and confusion.  In addition, ropinirole helps in the releasing neurotrophic factors which can improve the patients quality of life which is a not present in the medicines available today.

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