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Not too long ago I reported that after 7 years of study, they had concluded that Selegeline (Eldepryl) was neuroprotective. Below (at end) is the recent finding is the study I read to make that conclusion. However, I just received a further explanation from a movement disorder specialist at Vanderbilt (Nashville, TN) that I stated this incorrectly. Read his explanation: "Unfortunately that study looked only at the symptoms of Parkinson's disease and not disease progression. In there study design, any agent that provides symptomatic benefit will slow the progressions of symptoms. The authors state in their discussion that they can not comment on the possible neuroprotective effects of selegiline. As you know, there are many potential neuroprotective agents in various stages of study and the universal difficulty has been the lack of a reliable biomarker of disease progression that is not effected by symptomatic therapy by Dr. Thomas Davis Associate Professor of Neurology Director, Division of Movement Disorders Vanderbilt University School of Medicine This just goes to show you that the untrained eye can be easily misled. Peggy Neurology. 2006 Mar 15; [Epub ahead of print] Selegiline slows the progression of the symptoms of Parkinson disease. Abstract-- OBJECTIVE: To study the long-term effects of selegiline in monotherapy and in combination with levodopa in the early phase of Parkinson disease (PD). METHODS: One hundred fifty-seven de novo PD patients were randomized in a double-blind, placebo-controlled study of 7 years' duration. In the monotherapy part, selegiline significantly delayed the initiation of levodopa therapy vs placebo. The authors now report the results from the combination part of the study, in which 140 patients received selegiline or placebo in addition to individually tailored levodopa therapy. RESULTS: Compared with placebo, selegiline slowed the progression of disease disability as measured by the Unified Parkinson Disease Rating Scale (UPDRS)total score (p = 0.003) or by motor (p = 0.002) and Activities of Daily Living (p = 0.0002) subscores. After 5 years in combination therapy, the mean difference in the UPDRS total score was nearly 10 points, with patients receiving placebo having 35% higher scores. Simultaneously, patients receiving placebo needed progressively higher doses of levodopa than patients receiving selegiline; after 5 years, the mean dosage of levodopa was 19% higher with placebo than with selegiline (p = 0.0002). Considering the entire (monotherapy and combination therapy) 7-year study time, there was a trend for selegiline to delay the start of wearing-off fluctuations (hazard ratio 0.55, p = 0.08). In both phases of the study, selegiline was safe and well tolerated. CONCLUSIONS: The results of this long-term study confirm earlier findings indicating that selegiline delays the progression of the signs and symptoms of Parkinson disease. PMID: 16540603 [PubMed - as supplied by publisher] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn