Title:Parkinson's Disease, Diabetes and Cognitive Impairment
Volume: 10
Issue: 1
Author(s): Mohammad R. Ashraghi, Gennaro Pagano, Sotirios Polychronis, Flavia Niccolini and Marios Politis
Affiliation:
Keywords:
Cognition, Diabetes, DPP-4, GLP-1, Insulin Resistance, Neurodegeneration, Parkinson`s disease.
Abstract: Background: Parkinson’s disease is a chronic neurodegenerative disorder characterized by
a progressive loss of dopaminergic neurons. The pathophysiological mechanisms underlying Parkinson’s
are still unknown. Mitochondrial dysfunction, abnormal protein aggregation, increased neuroinflammation
and impairment of brain glucose metabolism are shared processes among insulinresistance,
diabetes and neurodegeneration and have been suggested as key mechanisms in development
of Parkinson’s and cognitive impairment.
Objective: To review experimental and clinical evidence of underlying Parkinson’s pathophysiology in common with diabetes
and cognitive impairment. Anti-diabetic agents and recent patents for insulin-resistance that might be repositioned in
the treatment of Parkinson’s also have been included in this review.
Method: A narrative review using MEDLINE database.
Results: Common antidiabetic treatments such as DPP4 inhibitors, GLP-1 agonists and metformin have shown promise in
the treatment of Parkinson’s disease and cognitive impairment in animals and humans. Study of the pathophysiology of
neurodegeneration common between diabetes and Parkinson’s disease has given rise to new treatment possibilities. Patents
published in the last 5 years could be used in novel approaches to Parkinson’s treatment by targeting specific pathophysiology
proteins, such as Nurr1, PINK1 and NrF2, while patents to improve penetration of the blood brain barrier
could allow improved efficacy of existing treatments.
Conclusion: Further studies using GLP-1 agonists and DPP-4 inhibitors to treat PD are warranted as they have shown
promise.
