Since the 1960s, pharmaceutical treatment of Parkinson's has predominantly involved drugs that target the dopamine system. These medications are often dopaminergic, which means they process or produce dopamine. Recent research, however, has begun to illuminate a potential non-dopaminergic approach to treating Parkinson's. It's based on the theory that neuroinflammation and insulin resistance play a significant role in the development and progression of Parkinson's.
The Background Research
In 2007, researchers investigated the benefits of non-steroidal anti-inflammatory drugs for Parkinson's. The authors observed that "inflammatory processes are involved in the pathophysiology of Parkinson's" and that "...neuroinflammation, a process orchestrated by activated resident microglia cells...might be perpetuating the neurodegenerative phenomenon."
In 2009, researchers found that microglia, the brain's immune cells, were activated in post-mortem brain samples from individuals with Parkinson's. This implies that a chronic inflammatory state is associated with Parkinson's.
Insulin resistance, typically associated with type 2 diabetes, has also been linked to Parkinson's. In 2010, researchers reported that people with Parkinson's tend to have high levels of insulin in their brains, which could contribute to dopamine neuron loss and the development of Parkinson's.
Subsequently, in 2016, researchers explored the role of insulin resistance in the progression of Parkinson's and found that diabetes and Parkinson's share common elements. They also found that an insulin-sensitizing drug may have promising effects for people with Parkinson's, and one analysis found that people with diabetes who took certain treatments to address insulin sensitivity were less likely to develop Parkinson's.
The research referenced above, along with the research that has preceded and followed it, has opened up a potentially new and exciting frontier in Parkinson's treatment. Ongoing clinical trials are exploring whether non-dopaminergic drugs can safely and effectively treat Parkinson's symptoms, as well as whether these treatments may slow Parkinson's progression.
Crucially, these non-dopaminergic approaches have also shown a potential to treat non-motor symptoms, which tend to be less responsive than motor symptoms to dopaminergic treatments. For example, one study of a treatment targeting neuroinflammation found that participants who received the trial drug experienced improvements in cognitive function.
Parkinson's is extraordinarily complicated, and we still don't fully understand what causes it or how it progresses. However, this new research into non-dopaminergic aspects of Parkinson's is beginning to show strong reasons for hope that new treatments are on the horizon and that these new treatments will help to dramatically improve quality of life for people living with Parkinson's.
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