Have there been any exciting breakthroughs recently?

In the past twenty years, there has been and continues to be exciting research in many different areas of Parkinson's disease.

 

These are some examples: 

 

Research on the cause of Parkinson's Disease:  Genetics and environment play a major role in the cause of Parkinson's Disease, even though age is the greatest risk factor. Knowing that PD is a heterogeneous disease, we realize that everyone has slightly different symptoms and that the underlying pathology varies for each group or person. In the past 15 years, more than 13 different genetic locations (loci) for PD have been identified, and we are likely just at the beginning for discovery of genetic causes. Learning about PD genetics helps understand the cause of PD and may lead to development of new treatments. Most genetic alternations deal with blocking the development of the abnormal proteins, their misfolding or their aggregation.

 

Research on non-motor and other symptoms of PD:  Over the last few years we have become aware of the non-motor symptoms in PD. These are anxiety, mood changes, slow thinking, and other cognitive symptoms, pain, alterations in sweating and temperature control, constipation, urinary and erectile dysfunction, and even visual symptoms like blurriness. They can occur anytime, but sometimes are associated with the "off" period. It is important to be aware of there non-motor symptoms, as they are very common and disturbing clinically and must be recognized so they can be treated. Several different medications are being studied for the management of non-motor symptoms.

 

Research in surgical treatment for PD:  There have been over 80,000 patients in the world that have had DBS for PD since it became available approximately 20 years ago. In patients with PD, with a robust response to levodopa, without marked cognitive impairment or uncontrolled neuropsychiatic symptoms this non-lesioning (nondestructive) surgery can be very beneficial clinically. New targets are in the future as are multiple targets.

 

Research of pathology of PD:  Studies on postmortem pathology on patients with PD and have found several subgroups of pathology that have different locations and seem to have a progression of advancement that seems to imply that the disease progresses similarly for many patients and may start in the olfactory nucleus (brain center for smell) and vagus nucleus (area of the brain involved in control of automatic functions). The pathological changes may likely advance to other brain areas. These findings if confirmed give us a possible pattern of progression of the disease and may offer a chance to make a diagnosis very early. This will be very important if we find drugs that allow for disease modification or neuroprotection.