Parkinson's Disease: current landscape, therapeutic challenges, and future perspectives

Abstract

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease worldwide, characterized by the progressive degeneration of dopaminergic neurons and the presence of motor and non-motor symptoms that significantly compromise patients' quality of life. Its prevalence increases with age, representing a growing challenge for global public health. This integrative review aimed to present a current overview of PD, highlighting therapeutic challenges and future perspectives in clinical management. To this end, a systematic search was conducted in the main databases between 2015 and 2024, selecting relevant articles in Portuguese, English, and Spanish. These were qualitatively analyzed using thematic categories related to diagnosis, treatment, and therapeutic advances. The findings highlight the etiological complexity of PD, involving genetic factors—such as mutations in the SNCA, LRRK2, and GBA genes—, environmental factors, and head trauma, as well as neuropathology associated with alpha-synuclein aggregation. Diagnosis still relies primarily on clinical evaluation, supplemented by imaging tests to rule out atypical syndromes. Current interventions combine pharmacological therapies, especially levodopa and dopamine agonists, with non-pharmacological and surgical approaches, including deep brain stimulation, which is effective for refractory motor symptoms. However, managing motor and non-motor complications remains a significant challenge, and disease-modifying therapies are still in their infancy. New therapeutic strategies, such as gene therapies, immunotherapies, and regenerative treatments, are under development, offering hope for the future. Therefore, this review highlights the importance of early diagnosis, multidisciplinary care, and scientific innovation to improve the prognosis and quality of life of patients with PD.