Systematic Review of Therapeutic Strategies for Reducing Parkinson's Disease Symptoms and Progression

Srihas Tumu; Venkata Yashashwini Maram Reddy; Navod Jayasuriya; Muaz Ali; Abdaal Munir; Iana Malasevskaia; Jamal Montaser

doi:10.7759/cureus.99206

Systematic Review of Therapeutic Strategies for Reducing Parkinson's Disease Symptoms and Progression

Cureus. 2025 Dec 14;17(12):e99206. doi: 10.7759/cureus.99206. eCollection 2025 Dec.

Authors

Srihas Tumu¹, Venkata Yashashwini Maram Reddy², Navod Jayasuriya³, Muaz Ali⁴, Abdaal Munir^{5

6}, Iana Malasevskaia⁷, Jamal Montaser¹

Affiliations

¹ Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
² Internal Medicine, Guntur Medical College, Guntur, IND.
³ Anesthesiology and Perioperative Medicine, Faculty of Medicine, University of Ruhuna, Galle, LKA.
⁴ Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
⁵ Surgery, College of Physicians and Surgeons Pakistan, Islammabad, PAK.
⁶ General Surgery, Wirral University Teaching Hospital, Birkenhead, GBR.
⁷ Obstetrics and Gynecology, Private Clinic 'Yana Alexandr', Sanaa, YEM.

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive decline, which plays a significant role in its pathogenesis. This systematic review aimed to evaluate the efficacy of therapeutic strategies in reducing symptoms and potentially slowing the progression of PD. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A systematic search was conducted across PubMed, MEDLINE, Europe PMC, EBSCO Open Dissertations, ScienceDirect, and the Cochrane Library for randomized controlled trials (RCTs) published between January 2015 and January 2025. Inclusion criteria focused on RCTs assessing therapeutic interventions aimed at slowing Parkinsonian symptoms and disease progression compared to placebo or standard care. Study quality was appraised using the Cochrane Risk of Bias-2 (RoB-2) tool. The review identified 15 RCTs that met the inclusion criteria. Interventions, such as exenatide and apomorphine, demonstrated improvements in motor symptoms, as measured by the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), often coupled with reductions in inflammatory markers like high-sensitivity C-reactive protein (hs-CRP). However, cognitive interventions yielded mixed results, showing benefits only in specific cognitive domains. The safety profiles varied significantly; for example, apomorphine (93% adverse events) exhibited substantially higher rates of adverse events compared to the placebo group (57%). Therapeutic strategies aimed at targeting PD symptoms show promise in managing both motor and non-motor manifestations of the disease. While benefits for cognitive decline are less consistent, these interventions warrant further investigation for their potential to slow overall disease progression. Future research should prioritize larger, multicenter RCTs with longer follow-up, explore combination therapies, and focus on identifying biomarkers for personalized treatment.

Keywords: cognitive decline prevention; neurodegenerative disorders; parkinson’s disease (pd); systematic literature review; therapeutic strategies.

Publication types

Review