NEW DIRECTIONS IN PARKINSONS RESEARCH AND TREATMENT

L-DOPA remains the mainstay of therapy for Parkinson's disease (PD). H owever, the side-effects associated with its chronic use have fuelled the search for novel strategies an alternative to simply supplementing dopamine deficiency. In reviewing the advances made over the last fiv e years, focus has been given to dopamine agonists, as well as to new MAO inhibitors that appear more effective than the currently used comp ound, selegiline. A number of new molecules acting at sites of the neu ronal circuit distal from lesioned dopaminergic neurones have also bee n considered, including NMDA antagonists, adenosine antagonists and an ticholinergic agents, this latter group representing the pioneering ap proach to PD treatment. In addition, new concepts of 'neuroprotection' have led to the exploitation of various agents, especially anti-oxida nts, directed toward slowing or halting disease progression. An entire ly new perspective has been provided by methods that apply the techniq ues of molecular biology to PD therapy and allow modified dopaminergic neurones capable of synthesising specific neurotrophic factors to be obtained by transfection. Parkinson's research has now progressed exte nsively, and further understanding of the aetiology of neuronal degene ration will disclose the key to the development of an effective therap y.