Management of early Parkinson's disease.

Hauser RA, Zesiewicz TA

Department of Neurology, 
Tampa General Hospital, Florida, USA
Med Clin North Am 1999 Mar;83(2):393-414, vi


The two major questions in the treatment of early PD are 
(1) Does selegiline slow neuronal loss and delay the progression of clinical disability? and 
(2) Should dopamine agonists be used as initial symptomatic therapy in early disease rather than levodopa/PDI to reduce long-term disability and delay the onset of motor fluctuations and dyskinesia?  
Selegiline affords neuroprotection for dopamine neurons in cell culture systems and the results of several clinical trials are consistent with the hypothesis that it is neuroprotective in Parkinson's disease
Several clinical trials have found that initial symptomatic therapy with dopamine agonist to which levodopa/carbidopa is later added when needed leads to a lower incidence of long-term motor complications.  These strategies are now being tested in prospective, randomized, blinded trials, many of which include PET or SPECT scans to assess the rate of dopamine neuron loss. These trials will provide more definitive answers to guide the early medial management of Parkinson's disease in the future.

Parkinson's research / abstracts

 1.    Deprenyl  effect on cognitive functions in early Parkinson's 
Deprenyl  depression in Parkinson's disease
Deprenyl  stimulates biosynthesis of interleukin-1 & 6
 4.    Deprenyl  effect of MAO-B inhibitors on MPP+ toxicity
 5.    Deprenyl  modulates the decline of the dopamineric system
 6.    Deprenyl 
possible mechanisms of action in Parkinson's 
7.    Deprenyl  pharmacological basis of the beneficial effects
Deprenyl  improves visuo-motor control in early Parkinsons
Deprenyl  delays disability in Parkinsonian patients
Deprenyl  management of early Parkinson's disease
Deprenyl  delays the onset of disability in Parkinsonian patients
Deprenyl  and tocopherol antioxidative therapy of Parkinsonism

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