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Treatment in early P arkinson's disease: the N orwegian P ark W est study
Author(s) -
Tveiten O. V.,
Skeie G. O.,
Haugarvoll K.,
Müller B.,
Larsen J. P.,
Tysnes O. B.
Publication year - 2013
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12055
Subject(s) - levodopa , medicine , dopaminergic , parkinson's disease , disease , cohort , clinical trial , norwegian , motor symptoms , symptomatic treatment , pediatrics , dopamine , physical therapy , linguistics , philosophy
Objectives There are limited data on treatment effect in early and drug‐naïve P arkinson's disease ( PD ) outside of clinical trials. We sought to review the treatment effects on motor symptoms in early, unselected PD patients. Methods We included 183 drug‐naïve patients from a longitudinal cohort ( T he N orwegian P ark W est study). At the time of diagnosis, motor symptoms were assessed and rated. Treatment was unrestricted, aimed at treating each patient optimally. P atients were reassessed after 12 months, and then grouped according to treatment: No dopaminergic treatment ( NDT ), dopamine agonists ( DA ) or levodopa. All strategies could be combined with monoamine oxidase B inhibitors. Results In general, the chosen treatment was coherent with current practice. During follow‐up, patients given NDT ( n = 40) had unaltered clinical motor symptoms, as opposed to improvement in the DA ‐ and levodopa‐treated patients ( n = 140). The overall improvement in these two groups was fairly similar, but axial symptoms did not improve in levodopa‐treated patients as opposed to the younger DA ‐treated patients. Conclusions Twelve months after the diagnosis, motor symptoms in approximately one‐fifth of PD patients remained clinically stable. Tremor, bradykinesia and rigidity improved in the dopaminergic‐treated patients. Axial symptoms were more treatment resistant, and the different symptomatic effects found between treatment strategies may be age related.