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Toward a New Era of Diagnosis and Treatment of Parkinson's Disease

Aging is also an essential factor for Parkinson's disease (PD); however, the cause of PD remains unknown. Levodopa has been the gold standard for symptomatic treatment since the introduction of intravenous levodopa in 1961. Even though many adjunctive medicines have been developed, developing disease-modifying therapies still need to catch up. It is almost 205 years since James Parkinson first reported “Shaking palsy” in 1827. In 1888, Charcot named that symptom adding muscle rigidity as Parkinson’s disease, in James Parkinson’s honor. After that, the discovery of Lewy bodies in the substantia nigra by Frederic H. Lewy in 1919, the discovery of Dopamine deficiency simultaneously by Sano and Ehringer in 1960, and the introduction of Levodopa as a therapeutic medicine, and the discovery of MPTP-induced Parkinsonism in 1983, which became breakthrough as the perspective that they led to the deterioration of mitochondrial function in sporadic PD. Since 1990, hereditary PD research has been accelerated as the discovery of the causative gene of familial Parkinson's disease PARK1(α-synuclein) in 1997 and the discovery of the causative gene of PARK2(parkin) by our group the following year. Additionally, inherited PD associated with single gene abnormality has been identified up to Park1-24. The number of PD patients is expected to increase further in ancient society, and it is said that the number of patients will reach 30 million worldwide by 2030. Therefore, elucidation of the disease condition is an urgent issue. In addition, the discovery of hereditary PD clearly shows that it is also associated with PD in young patients, and cooperation with Pediatric Neurologists is becoming critical. Neurology is evolving daily, and several new drugs have been launched in the last three years, even just in Parkinson’s disease area. The discretion of Neurologists is significant for PD treatment, and it may become more complicated by increasing the variety of drugs. The treatment of motor symptoms is the core of therapy, and the discretion of drugs is essential such as the use or combination use of Levodopa, Dopamine agonists, MAO-B inhibitors, COMT inhibitors, Anticholinergics, Adenosine A2a receptor antagonists. Furthermore, Device Aided Therapy has improved the long-term prognosis of motor symptoms. Although cell transplantation therapy and gene therapy are highly anticipated as near-future therapies, Disease-modifying therapy, which can prevent disease progression, is expected to be the ideal treatment. In this presentation, I will discuss the pathophysiology of PD, clinical data, and the discovery of abnormal α-synuclein seeds in the blood which we have identified.

The 46th Annual Meeting of the Japan Neuroscience Society

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[1LS04]Toward a New Era of Diagnosis and Treatment of Parkinson's Disease