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Rich Thompson,
        Concerning Dr. Iacono s comment concerning the *off* state I would
interpret it to mean that the  greatest damage is done to the Parkinson brain
in the *off* state whether  that be before commencing taking sinemet  or after
where *off* is defined as  being incapacitated from the Parkinson s symptoms.
        In other words if a person does not begin on sinemet after a reasonable
amount of time, and continues functioning in a slowed  down  state , that over
time this would be damaging.
 
Don
 
Dr. Don Berns
4943 Del Monte Rd.
La Canada, CA 91011
818-790-8812
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