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Lack of new drugs, diagnostic tests posing major challenge for neurologists treat Parkinson’s disease in India

Nandita Vijay, Bengaluru
Friday, April 21, 2017, 08:00 Hrs  [IST]

Lack of specific diagnostic tests and non availability of new drugs are posing a major challenge to medical practitioners in India for effectively treating Parkinson’s disease, a progressive neuro degenerative disorder.

According to experts from National Institute of Mental and Neuro Sciences (NIMHANS), Narayana Health City and Jain Institute Of Movement Disorders & Functional Neurosurgery (JIOMSN) part of Bhagwan Mahaveer Jain Hospital in Bengaluru, PD can happen to anybody. It does not affect everyone the same way and rate of progression differs among individuals.
In this disease, nerve cells in the brain transmitting neurotransmitter dopamine is decreased or even ceases to exist. This results in an aggravation of motor and non-motor disorders, said Dr BN Gangadhar, director, NIMHANS.

According to Dr Harirama K Acharya, senior consultant neurologist, Narayana Health City, no cure and access to specific diagnostic test for PD add to the woes of treatment.  Brain MRI imaging is performed to rule out disorders that mimic PD. SPECT scan is conducted only when a diagnostic dilemma exists. The drug regime comprises levodopa/carbidopa, pramipexole, ropinirole, and rotigotine, rasagiline, amantadine, trihexiphenidyl. Since no two people will react the same way to a given drug, it takes time to prescribe the right medication and dose. Surgery is considered for whom drug therapy is not sufficient. Deep brain stimulation viewed as a better option.
Stem cells could potentially be used to repair and replace damaged human tissue and is being tested though clinical research studies on patients,” noted Dr Acharya.
On the occasion of the Parkinson’s Awareness Week observed from April 10-16 and April 11 being the World Parkinson's Day, the disease was referred to as ‘shaking palsy’ by Dr James Parkinson in 1817. During the Parkinson's Awareness Week, to mark the 200th year of its existence, JIOMSN organised Walk-Inson 2017. The objective was to create awareness about treatment modalities stated, Dr. Sharan Srinivasan, neuro surgeon & director and Dr Sanjiv CC, neurologist for PD management from JIOMSN.
Over 10 million people worldwide suffer from PD but an estimated four percent are diagnosed before the age of 50. Men are 1.5 times more vulnerable than women. India accounts for around 1 million cases among those over 60 years. 'Juvenile Parkinsonism' in young people reported due to rare genetic mutations.
There are no effective preventive measures for PD. In India patients do not seek treatment early and do not access the right specialists . Hence the disease is not diagnosed or adequately treated until later stages. “Our country needs more movement disorders specialists. Only a handful of centres in the country offer Fellowship Training in Movement disorders like PD. There are no clinical studies in India but several new medication trials to prevent the progression of PD are underway in the western world and we will see the benefit of these in India too”, said Acharya.


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