The first-line treatment for Parkinson disease(PD), levodopa paired with carbidopa, did more than revolutionize treatment for PD when it entered use in the 1960s, it also largely replaced the use of neurosurgeries, especially pallidotomy and thalamotomy, that had been used in PD care since the beginning of the 20th century.
When it became evident that patients would experience dyskinesias and on/off periods after long-term use of levodopa, whether from the drug itself or from the disease's progression, attention returned to pallidotomy and thalamotomy in the 1990s.
Several experimental therapies for PD have so far dead-ended. Gamma-knife thalamotomy enjoyed brief interest but has now fallen by the wayside for PD nearly everywhere because of its high-risk adverse effect profile, Dr Martello said. Stem cell transplantation has similarly shown too many adverse effects, and gene therapy simply has not shown much benefit.
When it became evident that patients would experience dyskinesias and on/off periods after long-term use of levodopa, whether from the drug itself or from the disease's progression, attention returned to pallidotomy and thalamotomy in the 1990s.
Several experimental therapies for PD have so far dead-ended. Gamma-knife thalamotomy enjoyed brief interest but has now fallen by the wayside for PD nearly everywhere because of its high-risk adverse effect profile, Dr Martello said. Stem cell transplantation has similarly shown too many adverse effects, and gene therapy simply has not shown much benefit.
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