A recently published paper by Prof. Patrik Brundin and colleagues proposes a redefinition of the pathogenesis of Parkinson's into three progressive phases: triggers, facilitators, and aggravators.

Triggers are proposed agents or events that begin the disease process; these factors are necessary but insufficient for PD to develop.                                                                                                                                                    
Facilitators are factors that allow the disease to spread to, and significantly impact, the central nervous system.

Aggravators directly promote the neurodegenerative process and often have a snowballing effect that exacerbates pathology and spreads the disease beyond the basal ganglia.

Dr Simon Stott, Deputy Director of Research at The Cure Parkinson's Trust, said:

This new opinion piece from Prof. Brundin and colleagues provides us with not only a novel way of thinking about the disease course of Parkinson's, but it also emphasises the importance of administering specific treatments at relevant phases of the condition. Rather than simply seeking broad neuroprotective therapies which may have variable effects on each individual, the authors suggest that we should refine our approach by identifying compounds that inhibit certain 'facilitators' or 'aggravators' of Parkinson's, and apply them to individuals who present the symptoms of those targets. This more personalised method of treatment would hopefully slow down the progression of the condition and lead to improvements in quality of life. It is a very interesting idea they have proposed, and one which may now shape our approach to treating Parkinson's.

Read the full article here: 'Trends in Neurosciences' - Published:October 18 2018DOI:https://doi.org/10.1016/j.tins.2018.09.007