Progress in Parkinson's disease-where do we stand?

Parkinson's disease was first described in 1817 by James Parkinson. It is one of the most common neurodegenerative disorders, affecting the nigrostriatal pathways involved in the control of movement. Since the introduction of L-DOPA as a therapy in the mid-1960s, clinical management of the symptoms has progressed, but, at present, it remains impossible to stop the disease progression or to restore lost functions. A better understanding of neurodegeneration and of midbrain neuronal development has allowed the development of new pharmaceutical compounds with neuroprotective properties and has shown the potential of neurone replacement therapies in Parkinson's disease. Even though major obstacles remain before these can be transferred to the clinic, the progress made in the last 10 years brings hope of improved therapies for Parkinson's disease. In this paper we review the current knowledge of Parkinson's disease including its etiology, some of the current symptomatic therapeutic modalities, and recent progress in neuroprotective and cell replacement therapies.