New Therapeutic Strategies for Lewy Body Dementias.

Abstract

This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias. Disease-modifying approaches are aimed at preventing, slowing or ameliorating the production, aggregation and deposition of pathological proteins, including immunotherapy targeting α-synuclein and an ongoing trial using ambroxol which increases glucocerebrosidase activity to lower the levels of the protein alpha-synuclein. Other disease-modifying clinical trials are using agents to augment insulin signalling, stem cell therapy, reducing amyloid pathology and gene therapy.

• Authors: Latha Velayudhan, Dominic Ffytche, Clive Ballard, Dag Aarsland
• Journal: Current neurology and neuroscience reports (Curr Neurol Neurosci Rep) Vol. 17 Issue 9 Pg. 68 (Sep 2017) ISSN: 1534-6293 [Electronic] United States
• PMID: 28741230 (Publication Type: Journal Article, Review)

Chemical References

• Cholinesterase Inhibitors
• Piperidines
• alpha-Synuclein
• Urea
• pimavanserin

Topics

• Cholinesterase Inhibitors (therapeutic use)
• Disease Management
• Genetic Therapy (trends)
• Humans
• Lewy Body Disease (diagnosis, immunology, therapy)
• Parkinson Disease (diagnosis, immunology, therapy)
• Piperidines (therapeutic use)
• Stem Cell Transplantation (trends)
• Urea (analogs & derivatives, therapeutic use)
• alpha-Synuclein (immunology)