Multifunctional neuroprotective drugs for the treatment of cognitive and movement impairment disorders, including Alzheimer's and Parkinson's diseases

The concept of targeting multiple disease etiologies that lead to cognitive and movement impairment in neurodegenerative disorders, such as Alzheimer's disease, Parkinson's disease and stroke, is challenging the widely held assumption that silver bullet agents are superior to dirty in the pharmacological treatment of these diseases. Accumulating evidence in the literature suggests that a drug with two or more mechanisms of action targeted at multiple etiologies of the same disease may offer greater therapeutic benefit in certain disorders than a drug that targets only one disease etiology. In addition, the use of a single such multifunctional drug possessing several pharmacologically active moieties may yield a more favorable side effect profile than a combination of several drugs that individually target the same disease etiologies. In this review, we offer a synopsis of therapeutic strategies and novel investigative drugs developed in our own and other laboratories that modulate multiple disease targets associated with cognitive and movement impairment disorders, including cognitive decline associated with Alzheimer's disease, Parkinson's disease with dementia and movement deficits in Parkinson's disease.