Japanese

Title	Parkinson病及び関連疾患の治療の進歩 (2019)
Subtitle	特集 神経疾患治療の進歩2019 - 4
Authors	王子悠**, 服部信孝**
Authors (kana)
Organization	**順天堂大学医学部神経学講座
Journal	神経治療学
Volume	37
Number	5
Page	728-731
Year/Month	2020 /
Article	報告
Publisher	日本神経治療学会
Abstract	「はじめに」Parkinson病(Parkinson disease:PD)の治療は薬物治療を基本とするが, 近年デバイス療法である磁器刺激療法や経頭蓋直流電流刺激療法の有効性も多く報告されている. そして運動療法も新たな知見が得られている. さらに非運動症状に対しても様々な治療アプローチが試みられている. 本稿では2019年に発表された論文からPDおよびdouble-bind, randomized controlled trialで有効性が示されたものを中心に解説する. 「I. PDの治療法」「1. 運動症状に対する薬物療法」「1) 吸入用L-ドパ」PDのオフ時間の治療に用いられる新規L-ドパ吸入粉末薬(CVT-301)の効果・安全性を検証する第III相二重盲検ランダム化試験では, 1日のオフ時間が2時間以上でL-ドパ/脱炭酸酵素阻害薬で治療を受けている30〜85歳のPD患者でCVT-301 60mg, CVT-301 84mg, またはプラセボに1:1:1の割合で無作為に割り付けられた.
Practice	臨床医学：内科系
Keywords	Parkinson disease, motor symptom, non-motor symptom, disease modifying therapy

English

Title	Review / Advanced in Neurological Therapeutics (2019). Parkinson's disease and related disorders
Subtitle
Authors	Yutaka OJI, Nobutaka HATTORI
Authors (kana)
Organization	Department of Neurology, Juntendo University School of Medicine
Journal	Neurological Therapeutics
Volume	37
Number	5
Page	728-731
Year/Month	2020 /
Article	Report
Publisher	Japanese Society of Neurological Therapeutics
Abstract	We review reports published in 2019 providing new information on the management of Parkinson's disease (PD). L-dopa inhalation powder and sublingual apomorphine are effective on the motor symptom of off-state of PD patients. Rasagiline is safe and effective in monotherapy for patients with early-stage of PD. Zonisamide is effective against parkinsonism in patients with dementia with Lewy bodies (DLB). An oral preparation of nicotine has a significant improvement in scores of falls and freezing gait. Nicotine gum is effective for hypotension in PD patients. Fesoterodine improved nocturia and urinary urgency in PD patients. Percutaneous vagal nerve stimulation for PD patients with gastrointestinal complaints is a potential device for the non-invasive improvement of gastrointestinal symptoms. Incobotulinumotoxin A is effective on PD hypersalivation. Vinpocetine and intranasal insulin are effective for symptoms of cognitive impairment of PD. Aerobic exercise using gamed-virtual reality software and body weight supported treadmill training (BWSTT) were reported to be effective for PD. Probiotics significantly improved PD symptoms, and a significant improvement effect of licorice on motor symptoms was also reported. Treatment methods using medical devices are also advancing, such as Proprioceptive Focal Stimulation (Equistasi(R)) by nanotechnology equipment, high-frequency repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS) have been reported. Simultaneous stimulation of the subthalamic nucleus (STN) and substantia nigra reticulata (SNr) is effective for restless leg syndrome and nocturnal motor symptoms. A method that directly targets the dentatoruburothamic tract (DRTT) under the guidance of diffusion tensor imaging and tractography (DTIT) improves the tremor of PD patients. Finally, caloric vestibular stimulation (CVS) using a device called Thermo Neuro Modulation (TNM(TM)) improves motor and non-motor symptoms of PD.
Practice	Clinical internal medicine
Keywords	Parkinson disease, motor symptom, non-motor symptom, disease modifying therapy

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