Treatment Goals for Parkinson's Disease

Treatments for Parkinson’s disease (PD) focus on relieving or controlling the symptoms of PD for as long as possible, minimizing medication side effects, and improving quality of life. Treatment is individualized to each patient's specific needs, so patients will find themselves on different medications, dosages, and timing of dosages than other individuals. There is no known cure for PD, and there are no treatments that can change the course of the disease or stop the progression. Current research seeks ways to stop the progression of the disease.1

Medication goals of medication for motor symptoms

The motor symptoms of PD—resting tremor, bradykinesia (gradual loss and slowing down of spontaneous movement), rigidity, and postural instability (impaired balance)—are caused by reduced levels of the neurotransmitter dopamine in the brain. Dopamine is the chemical messenger that contributes to smooth, purposeful movement.

The main drug treatments used for PD help increase the dopamine levels in the brain, and by doing so, they relieve the symptoms of PD. Levodopa is a precursor to dopamine and is generally given as the initial treatment combined with carbidopa. Carbidopa keeps the body from turning levodopa into dopamine in the body, so that more of the levodopa gets to the brain. This also reduces the side effects caused by dopamine in the rest of the body. Other medications used to treat motor symptoms include monoamine oxidase (MAO)-B inhibitors, COMT inhibitors, and dopamine agonists.1,2

Treatment goals for non-motor symptoms

Not every person with PD develops the same symptoms, and not everyone develops the non-motor symptoms. But, the non-motor symptoms of PD can potentially be more disabling than the motor symptoms, and they can greatly impact a person’s quality of life.

Non-motor symptoms of PD affect a range of brain and body functions and include:

At the late stages of the disease, dementia can develop as a symptom of PD. Some of the non-motor symptoms are caused as a side effect of medications used to treat the motor symptoms, like levodopa. Management of these non-motor symptoms focuses on correcting any underlying problems that might be contributing to the symptom, reviewing all medications a person is taking, reducing or eliminating any medications that might be producing the symptom as a side effect, and adding other medications or therapies to alleviate the symptom.3

Physical therapy goals for Parkinson’s disease

Exercise therapy in people with PD improves motor symptoms and helps people maintain their functional independence. Goals of physical therapy and exercise are to help the patient improve their balance, mobility, speech, and other functional abilities.1,2

Surgical goals for Parkinson’s disease

Some people with PD with advanced-stage disease are candidates for surgery to help control motor symptoms. The surgery used is called deep brain stimulation, which involves the implantation and activation of electrodes into the brain. Goals of the surgery are to reduce motor symptoms that are not adequately controlled using medication.1,2

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Written by: Emily Downward | Last reviewed: November 2020