Treatment in early Parkinson's disease: the Norwegian ParkWest study
Article first published online: 29 NOV 2012
© 2012 John Wiley & Sons A/S
Acta Neurologica Scandinavica
Volume 128, Issue 2, pages 107–113, August 2013
How to Cite
Treatment in early Parkinson's disease: the Norwegian ParkWest study. Acta Neurol Scand 2013: 128: 107‒113. © 2012 John Wiley & Sons A/S., , , , , .
- Issue published online: 9 JUL 2013
- Article first published online: 29 NOV 2012
- Manuscript Accepted: 5 OCT 2012
- Western Norway Regional Health Authority. Grant Number: #911218
- Research Council of Norway. Grant Number: #177966
- Norwegian Parkinson Association's research foundation
- movement disorders;
- neurodegenerative disorders;
- Parkinson's disease;
There are limited data on treatment effect in early and drug-naïve Parkinson's disease (PD) outside of clinical trials. We sought to review the treatment effects on motor symptoms in early, unselected PD patients.
We included 183 drug-naïve patients from a longitudinal cohort (The Norwegian ParkWest study). At the time of diagnosis, motor symptoms were assessed and rated. Treatment was unrestricted, aimed at treating each patient optimally. Patients 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.
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.
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.