Comparative efficacy of surgical approaches to disease modification in Parkinson disease

Shervin Rahimpour, Su Chun Zhang, Jerrold L. Vitek, Kyle T. Mitchell, Dennis A. Turner

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Parkinson’s disease (PD) may optimally be treated with a disease-modifying therapy to slow progression. We compare data underlying surgical approaches proposed to impart disease modification in PD: (1) cell transplantation therapy with stem cell-derived dopaminergic neurons to replace damaged cells; (2) clinical trials of growth factors to promote survival of existing dopaminergic neurons; (3) subthalamic nucleus deep brain stimulation early in the course of PD; and (4) abdominal vagotomy to lower risk of potential disease spread from gut to brain. Though targeted to engage potential mechanisms of PD these surgical approaches remain experimental, indicating the difficulty in translating therapeutic concepts into clinical practice. The choice of outcome measures to assess disease modification separate from the symptomatic benefit will be critical to evaluate the effect of the disease-modifying intervention on long-term disease burden, including imaging studies and clinical rating scales, i.e., Unified Parkinson Disease Rating Scale. Therapeutic interventions will require long follow-up times (i.e., 5–10 years) to analyze disease modification compared to symptomatic treatments. The promise of invasive, surgical treatments to achieve disease modification through mechanistic approaches has been constrained by the reality of translating these concepts into effective clinical trials.

Original languageEnglish (US)
Article number33
Journalnpj Parkinson's Disease
Volume8
Issue number1
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
This work was supported by NIH UH3 NS103468 (D.A.T.).

Publisher Copyright:
© 2022, The Author(s).

PubMed: MeSH publication types

  • Review
  • Journal Article

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