The Next Frontier in Parkinson's Disease Treatment: A Narrative Review of Innovative Neurosurgical and Gene Therapy Approaches.

Background and Aims: Parkinson's disease (PD) is a progressive neurological condition that consists of both motor and non-motor symptoms that considerably deteriorate the quality of life. Pharmacological treatments, primarily levodopa, have been used to manage PD. However, side effects such as dyskinesias and motor fluctuations frequently limit their long-term effectiveness. In recent decades, breakthroughs and innovations in neurosurgical treatments have transformed the entire treatment landscape. Methods: This narrative review looks at clinical research focused on neurosurgical, gene therapy, and other modern methods for treating PD. Forty-seven studies were included in the search from PubMed, while three others were taken from other databases. Results: Deep brain stimulation (DBS) is the most established neurosurgical technique, and has strong evidence that it can improve motor symptoms. Focused ultrasound (FUS) provides a noninvasive option, but the majority of studies related to it still lack long-term data. Gene therapy strategies like AAV2-hAADC and ProSavin have shown early-phase safety and efficacy, but are still in early clinical stages. Newer imaging techniques and robotic surgery can play a critical role PD-related surgery, in the future. Conclusion: The range of PD treatment options is growing because of the newer neurosurgical and gene therapy approaches. The current results are promising, but larger-scale, controlled trials are required to show long-term safety and efficacy.