Doctors at the University of Maryland Medical Center have begun recruiting patients to evaluate potential new treatment options for movement disorders like Parkinson's disease. The experimental therapies are designed to provide more consistent relief of the basic symptoms of Parkinson's disease, such as involuntary shaking, slowness of movement and walking and balance problems. Later this year, the center also plans to offer a new research program for patients with Huntington's disease.
"The primary goals are to find new drugs that are effective for early symptoms and then continue to provide long-term relief with fewer side effects," says William J. Weiner, M.D., professor of Neurology at the University of Maryland School of Medicine and director of the University of Maryland Parkinson's Disease and Movement Disorders Program.
These clinical trials are part of larger multi-center studies that are evaluating the effectiveness of several medications, including rasagiline, entacapone and levodopa ethyl ester.
"We still have a long way to go in the treatment of movement disorders such as Parkinson's disease, Huntington's disease and Tourettes syndrome," says Lisa M. Shulman, M.D., associate professor of neurology at the University of Maryland School of Medicine and a co-director of the Parkinson's Disease and Movement Disorders Program.
"Our hope is that through studies like these, we can offer our patients improved daily function and improved quality of life," says Dr. Shulman.
Parkinson's disease is one of the most common movement disorders. It is a lifelong neurological condition that increasingly affects a person's ability to perform the normal activities of daily living. It is characterized by a tremor at rest, a general slowing of pace and a slow shuffling gait that may be associated with loss of balance. Speech can become soft and difficult to understand. Symptoms progress slowly over time.
Celebrities like Michael J. Fox, Janet Reno, Muhammad Ali and Pope John Paul II have fostered a global appreciation of Parkinson's disease, but there is still no known cause or cure for this disorder. Treatments that offer relief from symptoms often become less effective as the disease progresses. The irony is that drugs currently used to treat Parkinson's contribute to the development of yet another symptom known as dyskinesia, or drug-related involuntary movements. These movements resemble restless wriggling or even gyrating movements that at times can cause as much trouble as the Parkinson's itself.
"It's critical that we continue to look for more effective drugs that can more efficiently manage symptoms and restore function," says Dr. Shulman. "The onset of Parkinson's disease is often when people are in their 50s and 60s. These are important and productive decades of life."
Younger persons even those in their 30s and 40s can be affected. Approximately 10 percent of Parkinson's patients are younger than 50 at the onset of their disease. Fox, for example, is a young actor who resigned from a highly successful comedy series because the progression of Parkinson's disease. Earlier onset of the disorder requires careful selection of treatment options in order to minimize complications, since younger persons will require treatment over a much longer span of time.
Current research studies look at both new and existing drugs and analyze new combinations and dosages. "None of these drugs is perfect when prescribed alone," says Dr. Weiner. "We generally balance the effects of a variety of drugs to get the best possible results. We are always looking for new treatment options for our patients."
Dr. Weiner joined the University of Maryland Medical Center last fall and is co-author of a new book coming out this month on the topic. The book, Parkinson's Disease: A Complete Guide for Patients and Families, was co-authored by Dr. Shulman and Anthony E. Lang, M.D., professor of neurology at the University of Toronto. The book, a comprehensive resource for understanding the medical, emotional and practical challenges of life with Parkinson's disease, was published by Johns Hopkins University Press.
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