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Parkinsons disease: recent advances
Parkinsons disease (PD) has been one of the least researched and understood conditions for a long time. Since the 1980s, due to a significant body of new research and a breakthrough in neurology, the scientific understanding of its mechanisms and causes has improved (Ali, 2013). The improvements caused advancement in the treatment for PD through the high activation of dopamine.
The contemporary technologies are far more superior to those of the 1970s and 1980s. However, as concluded by Katzenschlager (2014), PD continues to be recognized as a neurodegenerative disorder of a relentlessly progressive nature. The major improvements have occurred in diagnosing the disease, allowing them to catch it at the early stages (Katzenschlager, 2014).
To ensure a detailed and deep analysis of the nature and mechanisms of the disease, it is critical to investigate its changes in the patients bodies at different stages, the potential root causes of the condition, its risks, and contributing factors. Such analysis contributes to a better understanding of the disease and the most vulnerable groups of patients. Katzenschlager (2014) specified that a set of new bio-markers and pre-motor manifestations were identified, pointing to PDs possibility.
Additionally, in the study by Torrent et al. (2015), the authors focused on examining the disease mechanisms using iPS cells for researching cell phenotypes related to PD to find new information about the pathogenesis of the condition that enables novel approaches to interventions. In that way, it is possible to notice that Parkinsons disease, one of the most complex neurodegenerative conditions known today, is being researched from various angles and, with the help of the latest technologies allowing a deeper and more informed insight on its dynamics and development.
The current perception of PD remains focused on patients genetics and the environmental factors as the major contributors to its occurrence (NIH, 2014). Several factors, such as diet, lifestyle, pesticides and pollution, harmful habits, and previous head injuries, are also researched regarding the correlation of their prevalence to the rates of PD (NIH, 2014). A condition as complex and multifaceted as Parkinsons disease requires lengthy and thorough research covering all the possible risk factors, manifestations, signs, and causes that are numerous in PD.
Similarly to PD, multiple sclerosis (MS) has been known to science for over 175 years; however, regardless of the known mechanisms, the variability of the conditions clinical course complicates the process of its diagnosing immensely (Broadley, 2013). MS is known to affect the central nervous system and be a condition of autoimmune, inflammatory nature. Also, the investigative approaches concentrate on the molecular aspect of MS. The current treatments for MS are focused on adjusting the immune system, thus preventing the inflammatory activity; they are delivered orally and parenterally (Keegan, 2013). A precise diagnosis and an accurate prediction of the conditions clinical course remain critical to the treatments success.
Neurostimulation therapies for primary headache disorders: Present and future
Magis, Jensen, and Schoenen (2015) focus on the treatments of the primary headache disorder, where the major challenge is the currently existing pharmacological treatments inefficiency. As an approach that has the potential to become a more effective intervention, the authors propose neurostimulation techniques that involve the use of electrical stimulations to minimize pain.
In particular, throughout the study, the researchers review the efficiency of ONS (occipital nerve stimulation) and DBS (deep brain stimulation). The former seemed to show unsatisfactory results in several trials attributed to the practical problems; however, Magis et al. (2015) concluded that additional research is required in this field since the problems with DBS were inflicted by an unknown factor. When it comes to ONS, its research testing seemed promising and especially helpful in chronic migraines. Also, the side effects of both approaches are much milder than those produced by pharmacological treatments.
Further, the researchers explore the effectiveness of the newer treatments, one of which is sphenopalatine ganglion (SPG) stimulation that is enabled with extracranial devices of different types and principles. Overall, it is found that the approach is partially effective (the pharmacological treatments criticized by the authors had a similar weakness). Also, the therapeutic effect of SPG stimulation was majorly dependent on the correct placement of the extracranial structure; the similar findings were reported in the study by Schuster, Vollbracht, and Rapoport (2015) that focused on the review of a variety of different treatments for the primary headache disorders such as cluster headaches and migraines. The latter study also finds that pharmaceutical, as well as device-assisted neuromodulation treatments, show promising results.
The studies noted that the proper administration of treatments of either kind (pharmaceutical and device-assisted) depends on multiple factors, and thus can contribute to the overall effectiveness of a given intervention.
Also, Wöber-Bingöl (2016) emphasized that these treatments are particularly complicated when it comes to addressing the primary chronic headaches in children who may be more susceptible to the side effects. In that way, working with the child patients, the necessity arises to provide a careful assessment and a very thorough evaluation of the risks and benefits of each available type of intervention as applied to any particular patient.
Moreover, it is important to point out that in addition to the existing neurostimulation therapies and pharmacological treatments, there are various alternative interventions such as intranasal delivery of triptan dihydroergotamine treatment, patch, and inhaled methods (Schuster et al., 2015).
References
Ali, N. (2013). Understanding Parkinsons disease: An introduction for patients and caregivers. New York, NY: Rowman & Littlefield.
Broadley, S. A. (2013). Multiple sclerosis: From molecules to treatment. International Journal of Molecular Sciences, 14, 7598-7602.
Katzenschlager, R. (2014). Parkinsons disease: recent advances. Journal of Neurology, 261, 10311036.
Keegan, B. M. (2013). Therapeutic decision making in a new drug era in multiple sclerosis. Seminars in Neurology, 33(1), 5-12.
Magis, D., Jensen, R., & Schoenen, J. (2012). Neurostimulation therapies for primary headache disorders: Present and future. Topics in Pain Management, 30(10), 1-12.
NIH. (2016). Parkinsons disease and environmental factos. Web.
Schuster, N., Vollbracht, S., & Rapoport, A. (2015). Emerging treatments for the primary headache disorders. Neurological Sciences, 36(S1), 109-113.
Torrent, R., De Angelis Rigotti, F., DellEra, P., Memo, M., Raya, A., & Consiglio, A. (2015). Using iPS Cells toward the Understanding of Parkinsons Disease. Journal Of Clinical Medicine, 4(4), 548-566.
Wöber-Bingöl, C. (2016). Acute treatment for primary headache disorders in children. New York, NY: Springer International Publishing.
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