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CHAPTER 10. ANTIPARKINSONIAN DRUGS

This group of drugs is used to treat Parkinson's disease as well as parkinsonism of different origins.

Parkinson's disease is a chronic neurodegenerative disease, in which the extrapyramidal system nuclei are affected. Usually the manifestations of this pathology include rigidity1 (significantly increased muscle tone), tremor (continuous involuntary trembling) and hypokinesia2 (decreased movement). The patient's gait is also altered. Gradually, mental disorders appear, and mental activity becomes impaired. Aetiology of Parkinson's disease is unknown3. However, it is known that in this disease in basal ganglia4 as well as in the substantia nigra there is a decrease in the concentration of dopamine, which has a mainly inhibitory effect on the neostriatum. The latter is involved in the control of the functions of the spinal cord. According to the current understanding, insufficiency of dopamine, associated with a decrease in the number of dopaminergic nigrostriatal neurons, is the basic cause of motor and mental disorders, which are a characteristic of parkinsonism.

In recent years it has been shown that in Parkinson's disease the main problem is the imbalance between dopaminergic and glutamatergic systems of the brain. As it has already been noted, in Parkinson's disease in the substantia nigra neurons there is a decreased level of dopamine that is supposed to

1 From Latin rigidus - hard, stiff.

2 From Greek hypo - under, lower, kinesis - motion.

3 In the 80's of the XX century MPTP compound (1-methyl-4phenyl-1.2.3.6-tetrahydropyridine) was derived from the heroin-type drug, used by drug abusers in the USA. MPTP caused a selective and irreversible destruction of dopamine nigrostriatal neurons in humans and animals. This was accompanied by motor symptoms of Parkinson's disease. This compound is suggested to be one of the causes of parkinsonism. However, this question still remains open since the sources of this substance are unknown, and it is unclear how it can penetrate into the human body. Now MPTP is used in pharmacology to obtain the experimental model of parkinsonism.

4 In the corpus striatum (unites two nuclei: nucleus caudatus and putamen; so-called neostriatum) and in the globus pallidus (paleostriatum).

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