Neuroprotection in Parkinson's disease: a realistic goal?

The current issue of CNS Neuroscience & Therapeutics contains an interesting review by Kinecses and Vecsei [1] on the progress in our knowledge related to the pathophysiological mechanisms of Parkinson's disease (PD) and on the development of putative neuroprotective molecules. Since the seminal discovery by Oleh Hornykiewicz that degeneration of DA neurons within the substantia nigra pars compacta (SNc) and the consequential dopamine depletion in the striatum was the cause of neurological symptoms in PD [2], thousands of reviews have been written on the subject, some of them possibly superfluous. Nevertheless, we found this last work enjoyable in terms of readability and in the way the authors decided to tackle such a difficult enterprise. This brief literature review is obviously far from comprehensive or exhaustive, as it would be impossible to summarize 50 years of fruitful research in the PD field in a few pages. The main contribution of this review is the general overview of the pathomechanism field and a survey of the literature that it provides on the hot topic of neuroprotection. Indeed, molecules able to slow and halt dopaminergic neuronal loss represent the highest ambition of PD research, drug companies and not least, patients. In recent years, research has advanced to the point that halting the progression of PD, restoring lost function, and even preventing the disease might be considered realistic goals [3]. Nevertheless the ultimate goal of preventing PD may take years to achieve, and no strong experimental confirmation hitherto is available for any of the compounds described by Kinecses and Vecsei [1] and others that the authors have not cited.