1. Recent developments in treatment of PD

2. Drug treatments L-DOPA still the mainstay Other dopamine agonists may prevent side effects

3. Lesion methods Lesions to subthalamic nucleus can control tremor

4. Deep brain stimulation Pacemaker like device implanted in subthalamic nucleus Reversible lesion

5. Implants of fetal cells 1 st double-blind placebo-controlled surgical trial reported in 2001 (Freed, NEJM). 40 patients, 20 received implants and 20 had placebo procedure PET images showed implants grew Little evidence for improvement after 1 year 15% had dyskinesia that could not be controlled by drugs

6. Whatever happened to J. William Langston? Director of Parkinson’s Institute in Sunnyvale CA. Still studying effects of environmental toxins on PD New findings suggest tobacco and caffeine exert protective effect

7. Whatever happened to the MPTP model? 150-200 new research reports/year Still the single most important model of PD A few mouse models now exist MPTP model is still most valuable way to test new drugs Eg continuous vs. pulsatile delivery and side- effects (Jenner) Eg continuous vs. pulsatile delivery and side- effects (Jenner)