Evidence-based treatment of Parkinson's disease

Nicholas D. Child, Bryan Klassen

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Parkinson's disease (PD) is one of the most common neurodegenerative disorders and is associated with neuronal loss in the dopaminergic neurons of the substantia nigra pars compacta, with resultant loss of striatal dopaminergic input. Levodopa therapy was the first treatment able to effect substantial improvement in motor symptoms and remains the most efficacious treatment for PD. This chapter analyzes how the first-line pharmacological treatments change the UPDRS motor score and affect the probability of motor fluctuations and dyskinesia in patients with early PD. It then examines to what extent do adjunctive pharmacologic therapies improve motor fluctuations or dyskinesia in patients with PD and levodopa-induced motor complications. The chapter also analyzes to what extent does deep brain stimulation targeting the subthalamic nucleus or globus pallidus interna improve motor fluctuations, dyskinesia, and quality of life in the patients. The trials discussed here include: the COMPARE trial, PD-SURG trial and the EARLYSTIM trial.

Original languageEnglish (US)
Title of host publicationEvidence-Based Neurology
Subtitle of host publicationManagement of Neurological Disorders: Second Edition
PublisherWiley-Blackwell
Pages191-208
Number of pages18
ISBN (Electronic)9781119067344
ISBN (Print)9780470657782
DOIs
StatePublished - Dec 11 2015

Keywords

  • Catechol-O-methyltransferase inhibitors
  • COMPARE trial
  • Deep brain stimulation
  • Dopamine agonists
  • EARLYSTIM trial
  • Levodopa-controlled release formulations
  • MAO-B inhibitors
  • Parkinson's disease
  • PD-SURG trial

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Child, N. D., & Klassen, B. (2015). Evidence-based treatment of Parkinson's disease. In Evidence-Based Neurology: Management of Neurological Disorders: Second Edition (pp. 191-208). Wiley-Blackwell. https://doi.org/10.1002/9781119067344.ch19