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Prevention

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Antioxidant compounds like urate may decrease risk of developing Parkinson's.

As of 2024, no disease-modifying therapies exist that reverse or slow neurodegeneration, processes respectively termed as neurorestoration and neuroprotection.[1][2] However, several behaviors and environmental factors have been found to be associated with a decreased risk.[1] The identification and mechanistis analysis of these inverse risk factors may guide the development of new therapies.[3]

Exercise—possibly the most frequently-recommended behavior to prevent or delay the progression of Parkinson's—is associated with a lower risk of developing the disease.[4] In animal studies investigating a possible cellular basis, exercise has been found to increase neurotrophic growth factor expression and to reduce alpha-synuclein expression, neuroinflammation, and mitochondrial dysfunction.[5]

Tobacco use and smoking is strongly associated with a decreased risk, reducing the chance of developing PD by 40–60%.[6][7] Various tobacco and smoke components have been hypothesized to be neuroprotective, including nicotine, carbon monoxide, and monoamine oxidase-B inhibitors.[8][9] Consumption of coffee, tea, or caffeine is also strongly associated with neuroprotection.[10][11] In laboratory models, caffeine has been shown to be neuroprotective due to its antagonistic interaction with the adenosine A2A receptor, which modulates dopaminergic signaling, synaptic plasticity, synapse formation, and inflammation.[8] Perscribed adrenergic antagonists like terazosin may also reduce risk.[10]

Although findings have varied—possibly due to disease mechanisms beyond inflamamtion, usage of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be neuroprotective.[12][13] Calcium channel blockers (CCB) may also have a protective effect, with a 22% risk decrease found in a 2024 meta-analysis of almost 3 million CCB users.[14] Higher blood concentrations of urate—a potent antioxidant—has been proposed to be neuroprotective;[8][15] animal and cell studies have shown that urate can prevent neurodegeneration of dopaminergic neurons.[15] Although longitudinal studies observe a slight decrease in PD risk among those who consume alcohol—possibly due to alcohol's urate-increasing effect—alcohol abuse may increase risk.[16][17]

References

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  1. ^ a b Crotty & Schwarzschild 2020, p. 1.
  2. ^ Fabbri et al. 2024, p. 2.
  3. ^ Rose, Schwarzschild & Gomperts 2024, p. 1267.
  4. ^ Crotty & Schwarzschild 2020, pp. 1–2.
  5. ^ Crotty & Schwarzschild 2020, pp. 4.
  6. ^ Ascherio & Schwarzschild 2016, p. 1262.
  7. ^ Grotewolda & Albina 2024, pp. 1–2.
  8. ^ a b c Grotewolda & Albina 2024, p. 2.
  9. ^ Rose, Schwarzschild & Gomperts 2024, pp. 268–269.
  10. ^ a b Grotewolda & Albina 2024, p. 3.
  11. ^ Ren & Chen 2020, p. 1.
  12. ^ Singh, Tripathi & Singh 2021, p. 10.
  13. ^ Ascherio & Schwarzschild 2016, pp. 1265–1266.
  14. ^ Lin et al. 2024, p. 1.
  15. ^ a b Ascherio & Schwarzschild 2016, p. 1263.
  16. ^ Ascherio & Schwarzschild 2016, p. 1261.
  17. ^ Kamal et al. 2020, p. 8.

Protection

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  • Ascherio A, Schwarzschild MA (2016). "The epidemiology of Parkinson's disease: risk factors and prevention". Lancet Neurology. 15 (12): 1257–1272. PMID 27751556.
  • Crotty GF, Schwarzschild MA (2020). "Chasing Protection in Parkinson's Disease: Does Exercise Reduce Risk and Progression?". Frontiers in Aging Neuroscience. 12: 1–11. PMID 32636740.
  • Singh A, Tripathi P, Singh S (2021). "Neuroinflammatory responses in Parkinson's disease: relevance of Ibuprofen in therapeutics". Inflammopharmacology. 29: 5–14. PMID 33052479.
  • Fabbri M, Rascol O, Foltynie T, Carroll C, Postuma RB, Porcher R, Corvol JC (2024). "Advantages and Challenges of Platform Trials for Disease Modifying Therapies in Parkinson's Disease". Movement Disorders: 1–10. PMID 38925541.
  • Kamal H, Tan GC, Ibrahim SF, Shaikh MF, Mohamed IN, Mohamed RM, Hamid AA, Ugusman A, Kumar J (2020). "Alcohol Use Disorder, Neurodegeneration, Alzheimer's and Parkinson's Disease: Interplay Between Oxidative Stress, Neuroimmune Response and Excitotoxicity". Frontiers in Cellular Neuroscience: 1–15. PMID 33061892.
  • Lin J, Pang D, Li C, Ou R, Yu Y, Cui Y, Huang J, Shang H (2024). "Calcium channel blockers and Parkinson's disease: a systematic review and meta-analysis". Therapeutic Advances in Neurological Disorders. 17: 1–8. PMID 38770432.
  • Grotewolda N, Albina RL (2024). "Update: Protective and risk factors for Parkinson disease". Parkinsonism and Related Disorders: 1–12. PMID 38879999.
  • Rose KN, Schwarzschild MS, Gomperts SN (2024). "Clearing the Smoke: What Protects Smokers from Parkinson's Disease?". Movement Disorders. 39 (2): 267–272. PMID 38226487.
  • Ren X, Chen J (2020). "Caffeine and Parkinson's Disease: Multiple Benefits and Emerging Mechanisms". Frontiers in Neuroscience: 1–12. PMID 33390888.
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