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Published in: Journal of Neural Transmission 9/2022

Open Access 13-06-2022 | Parkinson's Disease | Neurology and Preclinical Neurological Studies - Review Article

Disease modification in Parkinsonism: obstacles and ways forward

Authors: M. Höllerhage, M. Klietz, G. U. Höglinger

Published in: Journal of Neural Transmission | Issue 9/2022

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Abstract

To date, the diagnoses of Parkinson syndromes are based on clinical examination. Therefore, these specific diagnoses are made, when the neuropathological process is already advanced. However, disease modification or neuroprotection, is considered to be most effective before marked neurodegeneration has occurred. In recent years, early clinical or prodromal stages of Parkinson syndromes came into focus. Moreover, subtypes of distinct diseases will allow predictions of the individual course of the diseases more precisely. Thereby, patients will be enrolled into clinical trials with more specific disease entities and endpoints. Furthermore, novel fluid and imaging biomarkers that allow biochemical diagnoses are under development. These will lead to earlier diagnoses and earlier therapy in the future as consequence. Furthermore, therapeutic approaches will take the underlying neuropathological process of neurodegenerative Parkinson syndromes more specific into account. Specifically, future therapies will target the aggregation of aggregation-prone proteins such as alpha-synuclein and tau, the degradation of pathological aggregates, and the spreading of pathological protein aggregates throughout the brain. Many of these approaches are already in (pre)clinical development. In addition, anti-inflammatory approaches are in development. Furthermore, drug-repurposing is a feasible approach to shorten the developmental process of new drugs.
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Metadata
Title
Disease modification in Parkinsonism: obstacles and ways forward
Authors
M. Höllerhage
M. Klietz
G. U. Höglinger
Publication date
13-06-2022
Publisher
Springer Vienna
Published in
Journal of Neural Transmission / Issue 9/2022
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-022-02520-6

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