Latest Advance in Treatment of Parkinson’s Disease Dubai
UPDATE (October 14, 2019): Recently approved by the U.S. Food and Drug Administration (FDA) for treating Parkinson's "off" time – when symptoms re-emerge between doses – Nourianz (istradefylline) is now available by prescription.
Nourianz falls into the category of "adenosine A2A antagonists," working differently from current Parkinson’s drugs. By blocking the brain chemical adenosine, Nourianz enhances dopamine signaling, the brain chemical that decreases in Parkinson’s. It's a once-daily oral drug that can be added to a medication regimen with levodopa/carbidopa (brand name Sinemet) to reduce “off time.”
The approval of Nourianz adds to the growing list of treatments for “off” time, including COMT inhibitors like Comtan (entacapone) and MAO-B inhibitors like Azilect (rasagiline) and Xadago (safinamide). Another recently approved treatment, Inbrija, an inhaled levodopa, quickly reverses “off” time that comes on suddenly. Levodopa has been available for treating Parkinson’s Disease in Dubai for a long time.
Magnetic Resonance-guided Focused Ultrasound Therapy (MRgFUS)
FDA approves focused ultrasound for tremor-predominant Parkinson’s disease. December 19, 2018 Tremor-predominant Parkinson’s disease (PD) joins Essential tremor (ET) as an FDA-approved indication for the use of Focused ultrasound. This technology focuses ultrasound waves on a target to create a small lesion, disrupting abnormal Parkinson’s circuitry and treating motor symptoms.
Individual ultrasound waves are harmless, passing through the patient’s skull and brain tissue. Only when multiple waves focus on a spot is a lesion formed. In this approved procedure, MRI precisely directs ultrasound waves to the thalamus, a brain structure acting as a relay station.
Focused ultrasound is a non-invasive technology with the potential to improve the quality of life for Parkinson’s patients. It focuses ultrasonic energy on targets deep in the brain without damaging surrounding tissue. Though there is no cure for Parkinson’s, focused ultrasound offers a non-invasive alternative to surgery, potentially treating the underlying pathology.
Relief of Motor Symptoms
The FDA has approved focused ultrasound for treating tremor-dominated Parkinson’s disease.
Focused ultrasound may provide symptomatic relief by creating thermal lesions in the brain, interrupting circuits involved with tremor and dyskinesia. It targets Parkinsonian tremor, dyskinesia, and akinesia.
Advantages
- Non-invasive with reduced infection and blood clot risks.
- Precise targeting minimizes damage to healthy brain tissue.
- Unlike deep brain stimulation, it's a single procedure without battery replacements or adjustments.
Treating Underlying Pathology
Preclinical studies suggest focused ultrasound's potential to restore function in Parkinson’s models. It can temporarily open the blood-brain barrier to enhance drug delivery.
How Does It Differ from Deep Brain Stimulation?
The two procedures target the same brain areas. Focused ultrasound doesn't require brain wires, battery maintenance, or repeated programming appointments but is irreversible due to cell destruction.