Title:The Role of Monoamine Oxidase B Inhibitors in the Treatment of Parkinson’s
Disease - An Update
Volume: 22
Issue: 3
Author(s): Zhi Xin Chew, Chooi Ling Lim, Khuen Yen Ng, Soi Moi Chye, Anna Pick Kiong Ling and Rhun Yian Koh*
Affiliation:
- School of Health Sciences, International Medical University, No 126, Jalan Jalil Perkasa 19, Bukit Jalil 57000, Kuala
Lumpur, Malaysia
Keywords:
Parkinson’s disease, monoamine oxidase B inhibitor, selegiline, rasagiline, safinamide, neuroprotective.
Abstract: Parkinson’s disease (PD) is a progressive neurodegenerative disease characterised by reduced
dopamine levels in the substantial nigra. This may lead to typical motor features such as
bradykinesia, resting tremors and rigid muscles, as well as non-motor symptoms such as neuropsychiatric
symptoms, sleep disorders, autonomic dysfunction, and sensory disturbances. Inhibitors
of monoamine oxidase B (MAO-B) are used to alleviate symptoms by reducing monoamine
oxidase-catalysed degradation of dopamine; hence, preserving functional levels of dopamine. The
very first MAO-B inhibitor used therapeutically was selegiline, followed by rasagiline, its indane
derivative which has superior efficacy and selectivity. Both inhibitors can be used as monotherapy
or in combination with other anti- Parkinson drugs. Safinamide, a reversible MAO-B inhibitor that
utilises both dopaminergic and non-dopaminergic mechanisms, was recently approved by the European
Medicines Agency (EMA) (2015) and U.S. FDA (2017) as an add-on therapy for patients
with mid- or late-stage Parkinson’s disease. Furthermore, MAO-B inhibitors were found to be associated
with potential neuroprotective and disease modifying effects. However, evidence of their efficacy
and role in PD models is scarce and warrants further investigation.
