Abstract

Dopamine deficiency, caused by the degeneration of nigrostriatal dopaminergic neurons, is the cause of the major clinical motor symptoms of Parkinson's disease. These symptoms can be treated successfully with a range of drugs that include levodopa, inhibitors of the enzymatic breakdown of levodopa and dopamine agonists delivered by oral, subcutaneous, transcutaneous, intravenous or intra-duodenal routes. However, Parkinson's disease involves degeneration of non-dopaminergic neurons and the treatment of the resulting predominantly non-motor features remains a challenge. This review describes the important recent advances that underlie the development of novel dopaminergic and non-dopaminergic drugs for Parkinson's disease, and also for the motor complications that arise from the use of existing therapies.

Author affiliations

1. University Department of Clinical Neurosciences, Royal Free and University College Medical School, University College London, Rowland Hill Street, London NW3 2PF, UK.
2. Institute of Neurology, Queen Square, University College London, London WC1N 3BG, UK.
3. CNRS UMR 5543, Universite Victor Segalen–Bordeaux 2, 146, rue Leo Saignat, 33076 Bordeaux cedex, France.
4. Toronto Western Research Institute, Toronto Western Hospital, 399 Bathurst, MC 11-419, Toronto, Ontario M5T 2S8, Canada.
5. Molecular Endocrinology and Oncology Research Centre, Centre Hospitalier de l'Université Laval Research Centre (CHUL), Quebec (QC), Canada, G1V 4G2 and Faculty of Pharmacy, Laval University, Quebec G1K 7P4, Canada.
6. MRC Centre for Synaptic Plasticity, University of Bristol, University Walk, Bristol, BS8 1TD, UK.
7. Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany.
8. INSERM, UMR 679, Neurology and Experimental Therapeutics, Paris, France.
9. University Pierre et Marie Curie, Hôpital de la Pitié-Salpétrière, Paris, France.
10. Neurodegenerative Disease Research Centre, School of Health and Biomedical Sciences, King' s College, London SE1 1UL, UK.
11. Computational Neurobiology, EMBL-EBI. Wellcome-Trust Genome Campus, Hinxton, Cambridge CB10 1SD, UK.
12. Department of Neurology and Neuroscience Centre, Clinica Universitaria and Medical School, Universidad de Navarra and CIMA, Avenida de Pio XII, Pamplona 31008, Spain.
13. Department of Neurology, Massachusetts General Hospital, MassGeneral Institute for Neurodegenerative Disease, 114 16^th Street, Boston, Massachusetts 02129, USA.
14. 14 Unité Mixte de Recherche-Centre National de la Recherche Scientifique, (UMR-CNRS) 5541, Université Victor Segalen Bordeaux 2, 146 rue Léo Saignât, B.P. 31, 33076 Bordeaux Cedex, France.
15. Department of Cardiovascular Medicine and Neurology, Clinical and Scientific Affairs, Boehringer Ingelheim, 900 Ridgeway Road, Ridgefield, Connecticut CT06877, USA.

Correspondence to: Anthony H. V. Schapira^1,2 Email: a.schapira@medsch.ucl.ac.uk

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