The role of glutamatergic neurotransmission in the motor and non-motor symptoms in Parkinson's disease: Clinical cases and a review of the literature

Glutamate is the major excitatory neurotransmitter in central nervous system and, as such, many brain regions, including basal ganglia, are rich glutamatergic neurons. The importance of ganglia control voluntary movement has long been recognised, with effect dysfunction region exemplified by motor symptoms seen Parkinson’s disease (PD). However, and associated also play a role modulation emotion, nociception cognition, dysregulation which result some non-motor PD (depression/anxiety, pain cognitive deficits). Thus, while treatment traditionally approached from perspective dopaminergic replacement, using agents such levodopa dopamine receptor agonists, offers novel target for disease. Safinamide approved over 20 countries globally fluctuating add-on therapy to regimens management ‘off’ episodes. drug both non-dopaminergic pharmacological effects, latter inhibition abnormal glutamate release. safinamide on might present advantages dopamine-based therapies providing efficacy (levodopa-induced dyskinesia) well (anxiety, mood disorders, pain) symptoms. In this article, we discuss potential these symptoms, illustrative real-world examples patients have treated safinamide.