Parkinson S Disease Current And Future Therapeutics And Clinical Trials
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Néstor Gálvez-Jiménez,Hubert H. Fernandez,Alberto J. Espay,Susan H. Fox
Author : Néstor Gálvez-Jiménez,Hubert H. Fernandez,Alberto J. Espay,Susan H. Fox Publisher : Cambridge University Press Page : 385 pages File Size : 45,8 Mb Release : 2016-03-24 Category : Medical ISBN : 9781107053861
Parkinson's Disease: Current and Future Therapeutics and Clinical Trials by Néstor Gálvez-Jiménez,Hubert H. Fernandez,Alberto J. Espay,Susan H. Fox Pdf
This book emphasizes treatment options for Parkinson's disease, providing the necessary clinical and scientific basis for the foundations of solid therapeutics.
Parkinson’s Disease - Animal Models, Current Therapies and Clinical Trials by Sarat Chandra Yenisetti,Zevelou Koza,Devendra Kumar,Sushil Kumar Singh,Ankit Ganeshpurkar Pdf
Despite being described about 200 years ago, the pathophysiology of Parkinson’s disease (PD) is not well understood due to its complex etiology and heterogeneity of symptoms and progression. Animal models provide a great opportunity to follow the progression of neurodegeneration and to screen potent therapeutic molecules, knowledge of which can be critical for different levels of clinical trials. Contemporary health technologies are coming in handy to accelerate the pace of developing novel and refined therapeutic strategies for PD. This book, Parkinson’s Disease - Animal Models, Current Therapies and Clinical Trials, provides a comprehensive overview of PD, presenting information on animal models of PD and contemporary therapeutic strategies, health technologies, clinical trials, and their influence on the quality of life of patients with PD.
Recent Advances in Parkinson's Disease by Anonim Pdf
Recent Advances in Parkinson ́s Disease Research, Volume 252, represents a follow-up on two previous volumes presented in the Progress in Brain Research series, Volumes 193 and 193, both published in 2010. It contains a collection of overview articles written by leading researchers in Parkinson's, discussing the most important advances made in basic, translational and clinical research. Topics of note in this new release include What can we learn from iPS cell models of PD, What can we learn from animal models of PD?, Molecular basis of selective neuronal vulnerability in PD, Role of innate and adaptive immunity in Parkinson ́s disease, and much more. Covers all key aspects of current research on Parkinson ́s disease Includes topics that range from basic studies on disease models and pathogenic pathways (e.g., protein misfolding, immune and glial mechanisms) to clinical studies on disease features, microbiome, pathophysiology and therapeutic approaches Presents articles authored by world leaders in their respective fields
Clinical Trials In Parkinson's Disease by Santiago Perez-Lloret Pdf
This volume looks at major clinical trials for motor and non-motor symptoms in Parkinson’s Disease (PD) and covers important aspects, including trial design, sample selection, and outcome selection. Chapters in this book discuss topics such as toxin-based rodent or genetic models of PD; clinical trials for motor symptoms, L-DOPA related motor complications, and gait disorders; clinical trials for mood disorders, troubled sleep, autonomic dysfunction; and clinical trials for disease modifying therapies. In the Neuromethods series style, chapters include the kind of detail and key advice from the specialists needed to get successful results in your laboratory or research center. Cutting-edge and authoritative, Clinical Trials in Parkinson’s Disease is a valuable resource for clinicians and researchers who want to enhance their interpretation of results from clinical trials and to design their own high-quality trials.
Recent Advances in Parkinson's Disease: Translational and clinical research by Anders Björklund,M. Angela Cenci Pdf
This second volume follows on from Part I by reviewing the variety of animal models of PD current available (from drosophila to rodents to non-human primate species) and their specific contributions to PD research. This is followed by comprehensive coverage of functional neuroimaging studies that explore different pathophysiological questions and evaluate treatment outcome in PD patients. Different areas of experimental therapeutics and outstanding challenges to PD treatment are presented in a concluding group of articles. Complete overview of hot topics and approaches to current PD research, from molecules, to brain circuits, to clinical and therapeutic applications Leading authors review the state-of-the-art in their field of investigation, and provide their views and perspectives for future research All chapters include comprehensive background information and are written in a clear form that is also accessible to the non-specialist
Towards New Therapies for Parkinson's Disease by David Finkelstein Pdf
Parkinson's disease (PD) is characterised clinically by various non-motor and progressive motor symptoms, pathologically by loss of dopamine producing cells and intraneuronal cytoplasmic inclusions composed primarily of ?-synuclein. By the time a patient first presents with symptoms of Parkinson's disease at the clinic, a significant proportion of the cells in the substantia nigra have already been destroyed. This degeneration progresses despite the current therapies until the cell loss is so great that the quality of normal life is compromised. The dopamine precursor levodopa is the most valuable drug currently available for the treatment of PD. However for most PD patients, the optimal clinical benefit from levodopa decreases around five to six years of treatment. The aim of the chapters of this book is to work towards an understanding in the mechanisms of degeneration and to develop disease modifying therapies.
Etiology of Parkinson's Disease by Jonas H. Ellenberg,William C. Koller,James William Langston Pdf
This comprehensive reference provides a detailed overview of current concepts regarding the cause of Parkinson's disease-emphasizing the issues involved in the design, implementation, and analysis of epidemiological studies of parkinsonism.
National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders
Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders Publisher : National Academies Press Page : 111 pages File Size : 42,7 Mb Release : 2016-11-07 Category : Medical ISBN : 9780309442589
Neuroscience Trials of the Future by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders Pdf
On March 3-4, 2016, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders held a workshop in Washington, DC, bringing together key stakeholders to discuss opportunities for improving the integrity, efficiency, and validity of clinical trials for nervous system disorders. Participants in the workshop represented a range of diverse perspectives, including individuals not normally associated with traditional clinical trials. The purpose of this workshop was to generate discussion about not only what is feasible now, but what may be possible with the implementation of cutting-edge technologies in the future.
Inflammation in Parkinson's Disease by Madhavi Thomas Pdf
Parkinson’s Disease (PD) is a progressive neurodegenerative disease with a prevalence of 0.1% of the global population, and 5-10% patients are under 40 years of age. Several text books have been published on various aspects of PD to date, including research and clinical aspects. However these do not emphasize the inflammatory pathways and pathways of neurodegeneration in PD. Inflammation in Parkinson’s Disease brings advances in research together with current literature and evidence. This concise volume covers the fundamentals of neuroimmunology and inflammatory models, the interactions between pathways of neurodegeneration and follows the concept of research work undertaken from basic science to clinical trials. Researchers, clinicians, and students interested in Parkinson's Disease are provided with a comprehensive view of translational research methods and an insight needed for developing future therapies aimed at disease modulation.
Author : David Crosiers,Patrick Santens,K. Ray Chaudhuri Publisher : Frontiers Media SA Page : 90 pages File Size : 47,8 Mb Release : 2021-02-17 Category : Medical ISBN : 9782889664894
Non-motor Parkinson's Disease by Néstor Gálvez-Jiménez,Amos D Korczyn,Ramón Lugo-Sanchez Pdf
A comprehensive and practical manual describing the manifestations, pathophysiology and treatments for non-motor Parkinson's Disease. Topics covered in depth include autonomic and sexual dysfunction, mood disorders, sleep disturbances and drug-induced non-motor symptoms.
Institute of Medicine,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders
Author : Institute of Medicine,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders Publisher : National Academies Press Page : 107 pages File Size : 52,8 Mb Release : 2014-02-06 Category : Medical ISBN : 9780309292498
Improving and Accelerating Therapeutic Development for Nervous System Disorders by Institute of Medicine,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders Pdf
Improving and Accelerating Therapeutic Development for Nervous System Disorders is the summary of a workshop convened by the IOM Forum on Neuroscience and Nervous System Disorders to examine opportunities to accelerate early phases of drug development for nervous system drug discovery. Workshop participants discussed challenges in neuroscience research for enabling faster entry of potential treatments into first-in-human trials, explored how new and emerging tools and technologies may improve the efficiency of research, and considered mechanisms to facilitate a more effective and efficient development pipeline. There are several challenges to the current drug development pipeline for nervous system disorders. The fundamental etiology and pathophysiology of many nervous system disorders are unknown and the brain is inaccessible to study, making it difficult to develop accurate models. Patient heterogeneity is high, disease pathology can occur years to decades before becoming clinically apparent, and diagnostic and treatment biomarkers are lacking. In addition, the lack of validated targets, limitations related to the predictive validity of animal models - the extent to which the model predicts clinical efficacy - and regulatory barriers can also impede translation and drug development for nervous system disorders. Improving and Accelerating Therapeutic Development for Nervous System Disorders identifies avenues for moving directly from cellular models to human trials, minimizing the need for animal models to test efficacy, and discusses the potential benefits and risks of such an approach. This report is a timely discussion of opportunities to improve early drug development with a focus toward preclinical trials.
Deep Brain Stimulation for Parkinson's Disease by Gordon H. Baltuch,Matthew B. Stern Pdf
Considered the largest breakthrough in the treatment of Parkinson's disease in the past 40 years, Deep Brain Stimulation (DBS) is a pioneering procedure of neurology and functional neurosurgery, forging enormous change and growth within the field. The first comprehensive text devoted to this surgical therapy, Deep Brain Stimulation for Parkinson's
Autonomic Dysfunction in Parkinson's Disease by Cristian Falup-Pecurariu,Peter Jenner Pdf
Autonomic dysfunction is one of the most prevalent non-motor symptoms that occurs in Parkinson’s disease. Autonomic Dysfunction in Parkinson's Disease provides up to date information on this important topic, which affects quality of life of these patients. This include a large number of domains: orthostatic hypotension, excessive sweating, dry eyes, constipation, weight loss, increased sensitivity to heat and cold, sexual dysfunction. Provides comprehensive reviews on different topics of autonomic dysfunction in Parkinson’s disease Each chapter covers a specific autonomic symptom: classification, assessment, treatment Presents the newest information on each autonomic symptom in Parkinson’s disease
Levodopa pharmacokinetics -from stomach to brain by Maria Nord Pdf
Parkinson’s disease (PD) is one of the most common neurodegenerative disorders and it is caused by a loss of dopamine (DA) producing neurons in the basal ganglia in the brain. The PD patient suffers from motor symptoms such as tremor, bradykinesia and rigidity and treatment with levodopa (LD), the precursor of DA, has positive effects on these symptoms. Several factors affect the availability of orally given LD. Gastric emptying (GE) is one factor and it has been shown to be delayed in PD patients resulting in impaired levodopa uptake. Different enzymes metabolize LD on its way from the gut to the brain resulting in less LD available in the brain and more side effects from the metabolites. By adding dopa decarboxylase inhibitors (carbidopa or benserazide) or COMT-inhibitors (e.g. entacapone) the bioavailability of LD increases significantly and more LD can pass the blood-brain-barrier and be converted to DA in the brain. It has been considered of importance to avoid high levodopa peaks in the brain because this seems to induce changes in postsynaptic dopaminergic neurons causing disabling motor complications in PD patients. More continuously given LD, e.g. duodenal or intravenous (IV) infusions, has been shown to improve these motor complications. Deep brain stimulation of the subthalamic nucleus (STN DBS) has also been proven to improve motor complications and to make it possible to reduce the LD dosage in PD patients. In this doctoral thesis the main purpose is to study the pharmacokinetics of LD in patients with PD and motor complications; in blood and subcutaneous tissue and study the effect of GE and PD stage on LD uptake and the effect of continuously given LD (CDS) on LD uptake and GE; in blood and cerebrospinal fluid (CSF) when adding the peripheral enzyme inhibitors entacapone and carbidopa to LD infusion IV; in brain during STN DBSand during oral or IV LD treatment. To conclude, LD uptake is more favorable in PD patients with less severe disease and GE is delayed in PD patients. No obvious relation between LD uptake and GE or between GE and PD stage is seen and CDS decreases the LD levels. Entacapone increases the maximal concentration of LD in blood and CSF. This is more evident with additional carbidopa and important to consider in avoiding high LD peaks in brain during PD treatment. LD in brain increases during both oral and IV LD treatment and the DA levels follows LD well indicating that PD patients still have capacity to metabolize LD to DA despite probable pronounced nigral degeneration. STN DBS seems to increase putaminal DA levels and together with IV LD treatment also increases LD in brain possibly explaining why it is possible to decrease LD medication after STN DBS surgery. Parkinsons sjukdom (PS) är en av de vanligaste s.k. neurodegenerativasjukdomarna och orsakas av förlust av dopamin(DA)producerande nervceller i hjärnan. Detta orsakar motoriska symptom såsom skakningar, stelhet och förlångsammade rörelser. Levodopa (LD) är ett ämne, som kan omvandlas till DA i hjärnan och ge symptomlindring och det är oftast förstahandsval vid behandling av patienter med PS. Flera faktorer påverkar tillgängligheten av LD, bl.a. den hastighet som magsäcken tömmer sig med och denna verkar förlångsammad hos personer med PS vilket ger sämre tillgänglighet av LD i blodet och därmed i hjärnan. LD bryts även ner i hög grad av olika enzym ute i kroppen vilket leder till mindre mängd LD som hamnar i hjärnan och till fler nedbrytningsprodukter som orsakar biverkningar. Tillägg av enzymhämmare leder till ökad mängd LD som kan nå hjärnan och omvandlas till DA. Det anses viktigt att undvika höga toppar av LD i hjärnan då dessa verkar bidra till utvecklandet av besvärliga motoriska komplikationer hos patienter med PS. Om LD ges mer kontinuerligt, exempelvis som en kontinuerlig infusion in i tarmen eller i blodet, så minskar dessa motoriska komplikationer. Inopererande av stimulatorer i vissa delar av hjärnan (DBS) har också visat sig minska dessa motoriska komplikationer och även resultera i att man kan minska LD-dosen. Huvudsyftet med den här avhandlingen är att studera LD hos patienter med PS; i blod och fettvävnad då LD ges i tablettform och se om det finns något samband med LD-upptag och hastigheten på magsäckstömningen (MT) och om kontinuerligt given LD påverkar LD-upptaget eller MT; i blod och i ryggmärgsvätska då enzymhämmarna entakapon och karbidopa tillsätts LD; i hjärna vid behandling med DBS och då LD ges både som tablett och som infusion i blodet. Sammanfattningsvis kan vi se att LD-upptaget är mer gynnsamt hos patienter med PS i tidigare skede av sjukdomens komplikationsfas. MT är förlångsammad hos patienter med PS och det är inget tydligt samband mellan LD-upptag och MT eller mellan MT och sjukdomsgrad. Kontinuerligt given LD minskar LDnivåerna. Enzymhämmaren entakapon ökar den maximala koncentrationen av LD i blod och ryggmärgsvätska och effekten är mer tydlig vid tillägg av karbidopa vilket är viktigt att ta i beaktande vid behandling av PS för att undvika höga toppar av LD i hjärnan. LD ökar i hjärnan då man behandlar med LD i tablettform och som infusion i blodet och DA-nivåerna i hjärnan följer LD väl vilket visar på att patienter med PS fortfarande kan omvandla LD till DA trots trolig uttalad brist av de DA-producerande nervcellerna i hjärnan. DBS verkar öka DA i vissa områden i hjärnan och tillsammans med LD-infusion i blodet verkar det även öka LD i hjärnan och det kan förklara varför man kan sänka LDdosen efter DBS-operation.
