Details

Autor(en) / Beteiligte

• Fahn, Stanley
• Oakes, David
• Shoulson, Ira
• Kieburtz, Karl
• Rudolph, Alice
• Lang, Anthony
• Olanow, C Warren
• Tanner, Caroline
• Marek, Kenneth

Titel

Levodopa and the Progression of Parkinson's Disease

Ist Teil von

• The New England journal of medicine, 2004-12, Vol.351 (24), p.2498-2508

Ort / Verlag

Boston, MA: Massachusetts Medical Society

Erscheinungsjahr

2004

Quelle

MEDLINE

Beschreibungen/Notizen

• This randomized trial examined the effect of levodopa on the progression of Parkinson's disease. After 40 weeks of treatment followed by another 2 weeks for washout, the clinical severity of Parkinson's disease was greater in patients receiving placebo than in those treated with levodopa. However, neuroimaging data suggested a greater loss of dopamine nerve terminals in the patients treated with levodopa. In this randomized trial the clinical data indicate that levodopa reduces symptoms without accelerating clinical progression of Parkinson's disease. However, the neuroimaging data are not concordant. Parkinson's disease is a progressively disabling neurodegenerative disorder that is manifested clinically by bradykinesia, tremor, rigidity, flexed posture, postural instability, and freezing of gait. It is characterized pathologically by the loss of pigmented dopaminergic neurons in the substantia nigra. The course of the clinical decline parallels that of the progressive degeneration of the remaining dopaminergic neurons. 1 The use of levodopa as dopamine-replacement therapy is highly effective in ameliorating the symptoms of the disease and remains the standard drug with which other therapies are compared. 2 , 3 Because levodopa and dopamine can generate reactive oxygen species and induce the degeneration of cultured . . .