Current evidence on non-pharmacological approaches such as dietary changes, physical activity, and gut microbiome regulation are examined, focusing on their potential to modulate both peripheral and central immune responses, thereby influencing the progression of Parkinson's disease.
Abstract
Parkinson's disease (PD) imposes a growing socioeconomic burden due to its increasing prevalence and lack of a cure. Existing treatment options primarily manage motor and nonmotor symptoms but do not halt or slow disease progression, underscoring the urgent need for more effective and preventative strategies. Growing evidence suggests a strong link between immune system dysfunction, chronic inflammation, and the early pathogenesis of Parkinson's disease, often occurring years before the onset of motor symptoms, thereby indicating a critical window for early intervention. In this review, we examine current evidence on non-pharmacological approaches such as dietary changes, physical activity, and gut microbiome regulation, focusing on their potential to modulate both peripheral and central immune responses, thereby influencing the progression of PD. Besides being complementary to standard pharmacological treatments, these approaches not only reduce systemic inflammation but may also help delay, prevent, or improve clinical management of PD by targeting and modulating its immunological foundations.
Abstract Alzheimer's disease (AD) is a multifactorial neurodegenerative disease affecting various cognitive domains, requiring a holistic and integrated therapeutic approach. The treatment of AD goes beyond pharmacological interventions, also necessitating non-pharmacological therapies that can act synergistically, both with each other and with emerging pharmacological treatments, including new anti-amyloid therapies. These therapies aim to improve patients’ quality of life and alleviate behavioral symptoms, such as agitation and depression, and delay disease progression. Current clinical and meta-analytic evidence suggests that these approaches can be effectively integrated with conventional treatment, offering a valuable alternative to enhance patients’ overall well-being. However, further research is needed to deepen the understanding of the ideal combination of the new anti-amyloid therapies, to address the limitations of current evidence, and to robustly establish their effectiveness in the clinical context of AD, aiming to generate a broader and more lasting impact on disease treatment. This narrative review aims to synthesize the evidence on diverse non-pharmacological therapies for managing AD and discuss their practical implications for clinical care.
Gunaro Lucas Dos Santos de Oliveira, A. G. Bertollo· Dementia & Neuropsychologia· 0 citations
Parkinson's Disease (PD) is the second most common neurodegenerative disease after Alzheimer's Disease (AD), yet no effective disease-modifying therapy is currently available. Its pathogenesis is highly complex, involving multiple interacting pathological processes, which poses substantial challenges for therapeutic intervention. Moreover, PD often has a prolonged prodromal phase and lacks sufficiently sensitive and specific diagnostic methods for early-stage detection, further limiting timely identification and treatment. Current pharmacological therapies mainly provide symptomatic relief, but their long-term use is frequently associated with reduced efficacy and motor complications. Therefore, the development of novel therapeutic strategies and potential disease-modifying agents remains an urgent priority. This review systematically summarizes the molecular mechanisms and biomarkers associated with PD, outlines current symptomatic treatments, and discusses emerging therapeutic candidates in clinical development, with particular emphasis on disease-modifying strategies. By integrating pathogenic mechanisms, diagnostic advances, and therapeutic progress, this review aims to provide a comprehensive perspective to support the development of more effective interventions for PD.
Zhihui Shen, Jiaxin Cheng, Linlin Wang et al.· Current Neuropharmacology· 0 citations
As a progressive neurodegenerative disorder, Alzheimer's disease (AD) currently lacks curative treatments. Recent studies have demonstrated that gut dysbiosis modulates neuroimmune and metabolic pathways via the gut–brain axis and plays a pivotal role in AD pathological progression, which opens up new avenues for nutritional intervention. This paper systematically reviews multiple nutritional intervention strategies based on gut microecology regulation, including probiotics, prebiotics, polyphenolic antioxidants, omega‑3 fatty acids, and fecal microbiota transplantation (FMT). Such interventions exert certain protective effects by modulating gut microbiota composition, alleviating neuroinflammation, preserving blood‑brain barrier integrity, and slowing cognitive decline. Although existing clinical investigations have yielded several positive outcomes, the field is still confronted with prominent limitations such as high heterogeneity of intervention regimens, short follow‑up durations, small sample sizes, and inconsistent biomarkers and detection criteria. These drawbacks result in low levels of evidence, making it difficult to directly guide clinical practice. Furthermore, factors including poor patient adherence and interference from comorbidities and concomitant medications hinder the stable evaluation of intervention efficacy. Future research should rely on long‑term, multicenter, large‑sample randomized controlled trials (RCTs), combined with integrated multi‑omics analysis and individualized stratification strategies, to identify the most effective intervention combinations and their applicable populations. This review elaborates on mechanisms underlying the gut-brain axis, major nutritional intervention strategies, available clinical evidence, and prevailing challenges, aiming to provide references for subsequent research and translational applications in this field.
Xinyue Miao· Theoretical and Natural Scie...· 0 citations
Alzheimer’s disease (AD) is a chronic, progressive neurodegenerative condition that is characterized by an increasing incidence rate due to global population aging, resulting in a significant social and economic burden. Current pharmacological interventions offer only limited relief and are unable to halt neuronal loss and cognitive decline. Therefore, safe and effective non-pharmacological interventions (NPIs) are needed for the management of AD. This review systematically synthesizes literature from the PubMed and Web of Science databases (2020–2025) to evaluate the comparative efficacy of physical activity, dietary interventions, and cognitive stimulation therapy (CST), aiming to establish an evidence-based framework for optimized clinical implementation. Specifically, physical activity (e.g. aerobic exercise and strength training) has been shown to improve cognitive and physical function. Dietary interventions (e.g. the Mediterranean diet, Dietary Approaches to Stop Hypertension and The Mediterranean-DASH diet intervention for neurodegenerative delay diet) have been demonstrated to delay cognitive decline by modulating inflammation, but evidence regarding supplements is weak. Furthermore, CST has been evidenced to enhance patients’ cognitive abilities and quality of life. The present review not only summarizes existing literature on the subject, but also explores future research directions, including mechanisms and personalized approaches of these interventions to improve the prognosis of AD patients.
Jialin Chen, Ziyu Zhang· Frontiers in Aging Neuroscie...· 0 citations
Overall, saponins represent a promising avenue for the development of novel neuroprotective and disease-modifying therapies for PD, and challenges such as poor bioavailability in natural sources and limited access to brain remain significant barriers to clinical translation.
Debasmita Tripathy, Shreya Sen Sarma, Deepak Kumar et al.· Neurochemistry International· 0 citations
DMTs along with innovative therapeutic interventions reaching clinical trial testing and further development are summarized, offering patients more favorable treatment onset and opportunities for improved neurological impairment.
Letong Chen· Theoretical and Natural Scie...· 0 citations