This project is based on practice school.

1. “Emerging trends in Parkinson disease”
PRESENTED BY:
SHADAB AHMAD KHAN
ROLL NO - 844
ENROLLMENT NO: 2018-305-046
Under the Supervision of
Dr. Mohd. Akhtar
Department of Pharmacology
School of Pharmaceutical Education & Research
Jamia Hamdard, New Delhi-62

2. INTRODUCTION
01
Parkinson's disease (PD) is a neurological condition characterised by tremor,
hypokinesia, rigidity, and postural instability.
Symptoms start gradually, sometimes starting with a barely noticeable tremor in
just one hand. Tremors are common, but the disorder also commonly causes
stiffness or slowing of movement.

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Sign and Symptoms
02
Parkinson's disease signs and symptoms can be different for everyone. Early signs may be mild and go
unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even
after symptoms begin to affect both sides.
Parkinson's signs and symptoms may include:
Tremor
Slowed
movement
(bradykinesia).
Rigid muscles
Impaired
posture and
balance
Loss of
automatic
movements
Speech
changes
Writing
changes

4. Pathophysiology
03
• Physiologically, Parkinson's disease symptoms are
caused by the loss of a number of neurotransmitters,
most notably dopamine.
• The symptoms worsen over time as more and more of
the disease's cells are lost.
• The disease's progression is highly variable, with some
patients experiencing very few symptoms as they age
and others experiencing rapid progression.
DA Ach
DA
Ach
DA Ach
Parkinsonism
Normal
Balance Between
DA and ACH

5. 04
Diagnosis
 Currently, Parkinson disease is diagnosed based on clinical features from history and examination, as well as the
response to dopamine agents and the development of motor fluctuations over time.
Biomarkers for Diagnosis of Parkinson Disease
Imaging Biomarkers
To identify structural changes in the
substantia nigra, imaging techniques
such as MRI, transcranial sonography
(TCS), single-photon emission computed
tomography (SPECT), and positron
emission tomography (PET) have been
used.
These methods can estimate the levels of
dopamine transporter (DAT), vesicular
monoamine transporter (VMAT), post-
synaptic dopamine receptors, aromatic
amino acid decarboxylase activity, and
abnormal protein (α-synuclein and tau) or
iron accumulation in the midbrain or other
areas.
α-Synuclein
α-Synuclein biomarker potential in PD
and other synucleinopathies has been
extensively studied.
However, α-synuclein is expressed in a
variety of tissues and moves
bidirectionally between the blood and the
brain. As a result, determining whether
changes in α-synuclein levels in body
fluids reflect PD pathology in the brain
may be difficult.

6. Emerging trends in diagnosis of Parkinson Disease
05
XGBoost(eXtreme Gradient Boosting):
1
XGBoost is a new Machine Learning algorithm designed with speed and performance in mind
based on decision trees.
In this a Python programming is used. the Python libraries like scikit-learn, numpy, pandas,
and xgboost, are used to build a model using an XGBClassifier. Firstly, we load the data, get
the features and labels, scale the features, then split the dataset, build an XGBClassifier, and
then calculate the accuracy of our model. The following system will detect Parkinson’s
symptoms in the human body..
Biosensors
2
Graphene-based electrochemical sensing of dopamine used as they relate to point-of-care
testing suitable for the site-of-location diagnostics needed for personalized PD
management. In this field, the biosensors are developed into smartphone-connected
systems for intelligent disease management.

7. Emerging trends in treatment of Parkinson Disease 06
1.Stem Cell Therapy for Parkinson's Disease:
Stem cells have now been shown to be capable of differentiating into dopamine neurons that provide benefits following
transplantation in animal models of Parkinson's disease.
2. Immunotherapies:
In early human trials, both passive and active immunisation against this protein is being investigated. Passive
immunisation with monoclonal antibodies (mAbs) that target -synuclein aggregates, such as prasinezumab, has been
shown to reduce serum levels of free-synuclein by 97 percent.
3. Regenerative Therapies:
Cell-based regenerative therapies, using foetal brain cells, have been reported to be effective in a few cases.
4. Gene Therapy:
Gene therapy could be used to correct imbalances in basal ganglia circuitry associated with Parkinson's disease
symptoms, or to preserve or restore dopaminergic neurons lost during the disease process.
5. Melatonin therapy:
Administration of melatonin leads to inhibition of some pathways related to apoptosis, autophagy, oxidative stress,
inflammation, α-synuclein aggregation, and dopamine loss in PD.

8. Emerging trends in treatment of Parkinson Disease (conti..)
07
6. Autophagy in PD:
Dardarin, the product of an inherited PD mutation in LRRK2, belongs to the ROCO protein family. Some research
suggests a link between autophagy and LRRK2. Increased LRRK2 concentration activates macroautophagy via a
calcium-dependent pathway and increases autophagy receptor levels.
7. Monoamine oxide inhibitors:
The monoamine oxidase inhibitor selegiline is also used to treat Parkinson's disease. Selegiline works by prolonging the
action of dopamine in the striatum.
8. Iron targeting therapies:
Abnormal iron metabolism has been linked to Parkinson's disease, and increased intraneuronal iron load has been found
in the substantia nigra of patients with the disease.
9. Deep brain stimulation:
Here, electrodes are implanted into the subcortical structures surgically, to modulate the neural activity.

9. Future in treatment of Parkinson Disease 08
Drug/class Proposed mechanism Progress in trials
α-synuclein reduction α-synuclein reduction α-synuclein reduction
Isradipine Neuroprotection through blockade of L-type
calcium channels in substantia nigra
Multicentre phase III trial recently completed,
with no improvement in motor or quality of life
outcomes
Nilotinib Inhibition of ABL tyrosine kinase activity and
enhanced autophagy
Safe and tolerable but no clinical benefit in
phase II trial
Terazosin Activation of PGK1 and HSP90, increased ATP
levels, and reduced α-synuclein levels
Single-centre randomised placebo-controlled
trial currently enrolling patients
Deferiprone Iron chelation Phase II randomised double-blind placebo-
controlled trial completed, demonstrating
reduced iron content in.
Above these are some drugs which are under clinical trials for the new treatment medicine of Parkinson disease.

10. Conclusion
Since Parkinson disease doesn’t have cure but there are some recent advancements in the field of
diagnosis of Parkinson disease like using XGboost technology in this an algorithm used to detect
the early development of Parkinson disease. Another one is Biosensors used for the detection of
Parkinson disease.
New targeting area and biomarkers have found to act on specific target like Calcium targeting, Iron
targeting, Glucocerebrosidase etc.
Some new therapies have been developed like Stem cell therapy, Regenerative therapy, Gene
therapy, Immunotherapy etc. these therapies result in better management and treatment of
Parkinson disease. Some advancements have been done in reference to the previous treatment
method like Advancement in Deep brain stimulation which results in more effective treatment from
the previous one.
New drugs are being developed to treat and manage the Parkinson’s disease like Nilotinib, Inosine,
Exenatide, Isradipine, Deferiprone, etc. these drugs are in under clinical trail some are in phase 2
and phase 3.
09

11. References: -
1. Parkinson’s Disease and Its Management George DeMaagd, PharmD, BCPS and Ashok Philip, PhD, PMCID: PMC4517533 PMID:
26236139. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517533/
2. Epidemiology of Parkinson's disease Ole-Bjørn Tysnes 1, Anette Storstein PMID: 28150045 DOI: 10.1007/s00702-017-1686-y
https://pubmed.ncbi.nlm.nih.gov/28150045/#:~:text=Abstract,the%20population%20above%2060%20years.
3. Parkinson's Disease: Moving Forward Author: Lauren Robertson, BA, MPT https://www.atrainceu.com/content/2-pathophysiology-
parkinson%E2%80%99s-disease
4. Alpha-Synuclein as a Biomarker of Parkinson’s Disease: Good, but Not Good Enough Aging Neurosci., 08 July 2021 |
https://doi.org/10.3389/fnagi.2021.702639 https://www.nia.nih.gov/health/parkinsons-disease
5. https://www.frontiersin.org/articles/10.3389/fnagi.2021.702639/full
6. Parkinson disease onset detection Using Machine Learning! https://www.analyticsvidhya.com/blog/2021/07/parkinson-disease-
onset-detection-using-machine-learning/
7. Biosensors in Parkinson's disease Ahmad Mobed 1, Siamak Razavi 2, Ali Ahmadalipour 2, Seyed Kazem Shakouri 3, Ghazal
Koohkan PMID: 33753044 DOI: 10.1016/j.cca.2021.03.009 https://pubmed.ncbi.nlm.nih.gov/33753044/
8. https://www.nia.nih.gov/health/parkinsons-disease
9. https://www.dvcstem.com/post/stem-cell-therapy-for-parkinsons
10. Recent Advancements in Treatment for Parkinson’s Disease By Dr. Liji Thomas, MD Reviewed by Emily Henderson, B.Sc.
https://www.news-medical.net/amp/health/Recent-Advancements-in-Treatment-for-Parkinsone28099s-Disease.aspx
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12. THANK
YOU