Fortschr Neurol Psychiatr 2010; 78: S16-S19
DOI: 10.1055/s-0029-1245168
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Die Zukunft der invasiven Parkinson-Therapie

Parkinson’s Disease – the Future of Invasive TherapyG. Deuschl1
  • 1Neurologische Klinik der Christian-Albrechts-Universität zu Kiel
Further Information

Publication History

Publication Date:
01 March 2010 (online)

Zusammenfassung

Invasive Therapien haben in der Behandlung der Parkinson-Erkrankung eine lange Tradition. Während die tiefe Hirnstimulation bei fortgeschrittener Parkinson-Erkrankung mit Fluktuationen mittlerweile zu den etablierten Therapieverfahren zählt, sind für die Anwendung von Duodopa und Apomorphin noch Klasse I-Studien erforderlich. Die Transplantationen von fötalen Zellen und zukünftig vielleicht Stammzellen, und die Gentherapie gehören zu den zukünftig aussichtsreichen Interventionen.

Abstract

For the treatment of Parkinson’s disease invasive therapies have a long tradition. Deep brain stimulation is a well-established treatment option for the treatment of advanced Parkinson’s disease with fluctuations. Further promising interventions for invasive therapy of Parkinson’s disease are transplantation of foetal cells and stem cells, gene therapy and the use of duodopa and apomorhine.

Literatur

  • 1 Hassler R, Mundinger F, Riechert T. Stereotaxis in Parkinson Syndrome: Clinical-anatomical contributions to its physiology, with an atlas of the basal ganglia in Parkinsonism. Berlin, Heidelberg, New York; Springer Verlag 1979
  • 2 Lindvall O, Bjorklund A. Cell therapy in Parkinson’s disease.  NeuroRx. 2004;  1 382-393
  • 3 Bjorklund A. Intracerebral transplantation: prospects for neuronal replacement in neurodegenerative diseases.  Res Publ Assoc Res Nerv Ment Dis. 1993;  71 361-74
  • 4 Lindvall O, Rehncrona S, Brundin P. et al . Neural transplantation in Parkinson’s disease: the Swedish experience.  Prog Brain Res. 1990;  82 729-734
  • 5 Freed C R, Greene P E, Breeze R E. et al . Transplantation of embryonic dopamine neurons for severe Parkinson’s disease.  N Engl J Med. 2001;  344 710-719
  • 6 Olanow C W, Goetz C G, Kordower J H. et al . A double-blind controlled trial of bilateral fetal nigral transplantation in Parkinson’s disease.  Ann Neurol. 2003;  54 403-414
  • 7 Kordower J H, Chu Y, Hauser R A. et al . Transplanted dopaminergic neurons develop PD pathologic changes: a second case report.  Mov Disord. 2008;  23 2303-2306
  • 8 Kordower J H, Chu Y, Hauser R A. et al . Lewy body-like pathology in long-term embryonic nigral transplants in Parkinson’s disease.  Nat Med. 2008;  14 504-506
  • 9 Marks W J, Ostrem J L, Verhagen L. et al . Safety and tolerability of intraputaminal delivery of CERE-120 (adeno-associated virus serotype 2-neurturin) to patients with idiopathic Parkinson’s disease: an open-label, phase I trial.  Lancet Neurol. 2008;  7 400-408
  • 10 Eberling J L, Jagust W J, Christine C W. et al . Results from a phase I safety trial of hAADC gene therapy for Parkinson disease.  Neurology. 2008;  70 1980-1983
  • 11 Kaplitt M G, Feigin A, Tang C. et al . Safety and tolerability of gene therapy with an adeno-associated virus (AAV) borne GAD gene for Parkinson’s disease: an open label, phase I trial.  Lancet. 2007;  369 2097-2105
  • 12 Castaigne P, Laplane D, Dordain G. Clinical experimentation with apomorphine in Parkinson’s disease.  Res Commun Chem Pathol Pharmacol. 1971;  2 154-158
  • 13 Stibe C M, Kempster P A, Lees A J. et al . Subcutaneous apomorphine in parkinsonian on-off oscillations.  Lancet. 1988;  331 403-406
  • 14 Poewe W, Kleedorfer B, Gerstenbrand F. et al . Subcutaneous apomorphine in Parkinson’s disease.  Lancet. 1988;  1 943
  • 15 Wenning G K, Bösch S, Luginger E. et al . Effects of long-term, continuous subcutaneous apomorphine infusions on motor complications in advanced Parkinson’s disease.  Adv Neurol. 1999;  80 545-548
  • 16 Gunzler S A, Koudelka C, Carlson N E. et al . Effect of low concentrations of apomorphine on parkinsonism in a randomized, placebo-controlled, crossover study.  Arch Neurol. 2008;  65 193-198
  • 17 Dewey R B, Hutton J T, LeWitt P A. et al . A randomized, double-blind, placebo-controlled trial of subcutaneously injected apomorphine for parkinsonian off-state events.  Arch Neurol. 2001;  58 1385-1392
  • 18 Antonini A, Isaias I U, Canesi M. et al . Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome.  Mov Disord. 2007;  22 1145-1149
  • 19 Nutt J G, Jansson R, Willows T. et al . Long-term 24-hour duodenal infusion of levodopa: outcome and dose requirements.  Neurology. 2005;  65 1506-1507
  • 20 Nyholm D, Nilsson Remahl A IM, Dizdar N. et al . Duodenal levodopa infusion monotherapy vs oral polypharmacy in advanced Parkinson disease.  Neurology. 2005;  64 216-23
  • 21 Weaver F M, Follett K, Stern M. et al . Bilateral deep brain stimulation vs. best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial.  Jama. 2009;  301 63-73
  • 22 Deuschl G, Schade-Brittinger C, Krack P. et al . A randomized trial of deep-brain stimulation for Parkinson’s disease.  N Engl J Med. 2006;  355 896-908
  • 23 Deep-Brain Stimulation for Parkinson’s Disease Study Group . Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson’s disease.  N Engl J Med. 2001;  345 956-963
  • 24 Rodriguez-Oroz M C, Obeso J A, Lang A E. et al . Bilateral deep brain stimulation in Parkinson’s disease: a multicentre study with 4 years follow-up.  Brain. 2005;  128 2240-2249
  • 25 Okun M S, Fernandez H H, Wu S S. et al . Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial.  Ann Neurol. 2009;  65 586-595
  • 26 Coban A, Hanagasi H A, Karamursel S. et al . Comparison of unilateral pallidotomy and subthalamotomy findings in advanced idiopathic Parkinson’s disease.  Br J Neurosurg. 2009;  23 23-29
  • 27 Volkmann J, Allert N, Voges J. et al . Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD.  Neurology. 2001;  56 548-551
  • 28 Stefani A, Lozano A M, Peppe A. et al . Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease.  Brain. 2007;  130 1596-1607
  • 29 Hamani C, Stone S, Laxton A. et al . The pedunculopontine nucleus and movement disorders: anatomy and the role for deep brain stimulation.  Parkinsonism Relat Disord. 2007;  13 (Suppl 3) S276-S280
  • 30 Smith Y, Raju D, Nanda B. et al . The thalamostriatal systems: anatomical and functional organization in normal and parkinsonian states.  Brain Res Bull. 2009;  78 60-68
  • 31 Plaha P, Gill S S. Bilateral deep brain stimulation of the pedunculopontine nucleus for Parkinson’s disease.  Neuroreport. 2005;  16 1883-1887
  • 32 Alvarez L, Macias R, Pavón N. et al . Therapeutic efficacy of unilateral subthalamotomy in Parkinson’s disease: results in 89 patients followed for up to 36 months.  J Neurol Neurosurg Psychiatry. 2009;  80 979-985
  • 33 Merello M, Tenca E, Pérez Lloret S. et al . Prospective randomized 1-year follow-up comparison of bilateral subthalamotomy versus bilateral subthalamic stimulation and the combination of both in Parkinson’s disease patients: a pilot study.  Br J Neurosurg. 2008;  22 415-422
  • 34 Tass P A, Silchenko A N, Hauptmann C. et al . Long-lasting desynchronization in rat hippocampal slice induced by coordinated reset stimulation.  Phys Rev E Stat Nonlin Soft Matter Phys. 2009;  80 011 902
  • 35 Hauptmann C, Tass P A. Cumulative and after-effects of short and weak coordinated reset stimulation: a modeling study.  J Neural Eng. 2009;  6 016 004
  • 36 Hauptmann C, Popovych O, Tass P A. Desynchronizing the abnormally synchronized neural activity in the subthalamic nucleus: a modeling study.  Expert Rev Med Devices. 2007;  4 633-650

Prof. Dr. Günther Deuschl

Neurologische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel

Schittenhelmstr. 10

24105 Kiel

Email: g.deuschl@neurologie.uni-kiel.de

    >