this articlefrom WE-MOVE reflects my impression of this subject
comparing UPDRS and SPECT are almost separate issues
what is interesting is the lack of a control group
a little late now, though the data can be gathered
it would be necessary to give a placebo to another set of patients
and maybe even a normal set of volunteers
ray
-------------------------------------------------------------------------
>Dopamine transporter brain imaging to assess the effects of pramipexole
>vs. levodopa on Parkinson disease progression
>Parkinson Study Group
>JAMA. 2002;287:1653-1661
>
>Initial treatment of PD with pramipexole slows nigral cell loss compared
>to levodopa, according to this study.
>
>Patients in this study were a subset of the CALM-PD study, a double-blind
>study comparing initial pramipexole to initial levodopa in the development
>of motor complications. E-MOVE's report on this study is archived at
>http://www.wemove.org/emove/article.asp?ID=223.
>
>Rate of dopaminergic cell loss was assessed longitudinally by
>beta-CIT-SPECT imaging in 82 patients, 42 of whom initially received
>levodopa, and 40 of whom initially received pramipexole. The mean
>percentage loss of uptake in the two groups at each time point compared to
>baseline was:
>
>22 months: pramipexole 7.1%, levodopa 13.5% (p=0.004)
>34 months: pramipexole 10.9%, levodopa 19.6% (p=0.009)
>46 months: pramipexole 16.0%, levodopa 25.5% (p=0.01)
>
>While worsening in UPDRS scores correlated with declining uptake for
>patients grouped as a whole, no significant difference was found between
>treatments at the 46-month evaluation (motor score increased 1.0 for
>pramipexole, 2.1 for levodopa). The authors suggest that longer-term
>follow-up will be required to assess any correlations between imaging and
>clinical outcomes.
>
>The authors note, "Since this study compared 2 active medications without
>a placebo group, these data cannot directly distinguish whether the
>difference in the rate of loss of beta-CIT uptake in the treatment groups
>results from a decrease due to pramipexole, an increase due to levodopa,
>or both." However, they argue that preclinical and other evidence suggest
>a protective effect of pramipexole is more likely.
>
>==========================================================================
>Copyright 2002 WE MOVE
>Editor: Richard Robinson ([log in to unmask])
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Ray Strand
Prairie Sky Design
-----------------( on the Edge of the Prairie Abyss )---------------
when the sky is clear
the ground is visible
50/47dx PD/40? onset
http://folding.stanford.edu
join MSA TEAM CURE
#2508
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