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In the past two decades, there has been concern that levodopa—the gold-standard therapy for Parkinson disease (PD)—may be toxic to dopaminergic neurons. However, findings from a recent study suggest that chronic use of levodopa does not enhance progression of PD pathology. Can we make sense of this controversy?
Neurological markers are used to predict outcomes in patients resuscitated after cardiac arrest, and are crucial in informing treatment decisions in comatose patients. A multicenter study reports that therapeutic hypothermia in cardiac arrest alters the reliability of several recommended prognostic parameters, and the authors highlight challenges to optimization of prognostic paradigms.
Depression is a common symptom in patients with Parkinson disease (PD), and is found at higher rates in these individuals than in healthy populations or patients with other neurodegenerative disorders. Aarsland et al. discuss both the course of depression and the mechanisms that may contribute to the enhanced susceptibility to depression in patients with PD. Management strategies to control depression in these individuals are also highlighted.
The discovery of mutations that contribute to movement disorders has facilitated the identification of converging pathways and novel therapeutic targets. Successful translation of these research findings into clinical practice will require identification of early markers of disease progression, and recent research indicates that progress is being made in this area.
Defects in autophagy—a process that enables the degradation of unwanted or damaged intracellular proteins and organelles—are associated with the accumulation of aggregate-prone proteins. Defects in neuronal autophagy may have a role in neurodegenerative disease that are associated with aberrant protein accumulation, such as Alzheimer disease and Parkinson disease. Rubinsztein and Harris discuss how defects in autophagic pathways might cause these diseases and highlight how autophagy-modulating drugs might be used as therapy.
The first-in-human phase I trial of stem cell transplantation for amyotrophic lateral sclerosis was approved by the FDA in 2009 and is ongoing. In their Perspectives article, Eva Feldman and colleagues, who are conducting the trial, discuss the preclinical research supporting this therapeutic approach, key aspects of the trial design to overcome translational issues, and ongoing challenges to address in future studies.