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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Activity enhances dopaminergic long-duration response in Parkinson disease</title>
<author><name sortKey="Jung Kang, Un" sort="Jung Kang, Un" uniqKey="Jung Kang U" first="Un" last="Jung Kang">Un Jung Kang</name>
</author>
<author><name sortKey="Auinger, Peggy" sort="Auinger, Peggy" uniqKey="Auinger P" first="Peggy" last="Auinger">Peggy Auinger</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">22459675</idno>
<idno type="pmc">3466780</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466780</idno>
<idno type="RBID">PMC:3466780</idno>
<idno type="doi">10.1212/WNL.0b013e31824f8056</idno>
<date when="2012">2012</date>
<idno type="wicri:Area/Pmc/Corpus">000629</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000629</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Activity enhances dopaminergic long-duration response in Parkinson disease</title>
<author><name sortKey="Jung Kang, Un" sort="Jung Kang, Un" uniqKey="Jung Kang U" first="Un" last="Jung Kang">Un Jung Kang</name>
</author>
<author><name sortKey="Auinger, Peggy" sort="Auinger, Peggy" uniqKey="Auinger P" first="Peggy" last="Auinger">Peggy Auinger</name>
</author>
</analytic>
<series><title level="j">Neurology</title>
<idno type="ISSN">0028-3878</idno>
<idno type="eISSN">1526-632X</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>We tested the hypothesis that dopamine-dependent motor learning mechanism underlies the long-duration response to levodopa in Parkinson disease (PD) based on our studies in a mouse model. By data-mining the motor task performance in dominant and nondominant hands of the subjects in a double-blind randomized trial of levodopa therapy, the effects of activity and dopamine therapy were examined.</p>
</sec>
<sec><title>Methods:</title>
<p>We data-mined the Earlier versus Later Levodopa Therapy in Parkinson's Disease (ELLDOPA) study published in 2005 and performed statistical analysis comparing the effects of levodopa and dominance of handedness over 42 weeks.</p>
</sec>
<sec><title>Results:</title>
<p>The mean change in finger-tapping counts from baseline before the initiation of therapy to predose at 9 weeks and 40 weeks increased more in the dominant compared to nondominant hand in levodopa-treated subjects in a dose-dependent fashion. There was no significant difference in dominant vs nondominant hands in the placebo group. The short-duration response assessed by the difference of postdose performance compared to predose performance at the same visit did not show any significant difference between dominant vs nondominant hands.</p>
</sec>
<sec><title>Conclusions:</title>
<p>Active use of the dominant hand and dopamine replacement therapy produces synergistic effect on long-lasting motor task performance during “off” medication state. Such effect was confined to dopamine-responsive symptoms and not seen in dopamine-resistant symptoms such as gait and balance. We propose that long-lasting motor learning facilitated by activity and dopamine is a form of disease modification that is often seen in trials of medications that have symptomatic effects.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Neurology</journal-id>
<journal-id journal-id-type="iso-abbrev">Neurology</journal-id>
<journal-id journal-id-type="hwp">neurology</journal-id>
<journal-id journal-id-type="publisher-id">neur</journal-id>
<journal-id journal-id-type="pmc">neurology</journal-id>
<journal-id journal-id-type="publisher-id">WNL</journal-id>
<journal-title-group><journal-title>Neurology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0028-3878</issn>
<issn pub-type="epub">1526-632X</issn>
<publisher><publisher-name>Lippincott Williams & Wilkins</publisher-name>
<publisher-loc>Hagerstown, MD</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22459675</article-id>
<article-id pub-id-type="pmc">3466780</article-id>
<article-id pub-id-type="publisher-id">WNL203603</article-id>
<article-id pub-id-type="doi">10.1212/WNL.0b013e31824f8056</article-id>
<article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>161</subject>
<subject>313</subject>
<subject>165</subject>
<subject>243</subject>
</subj-group>
<subj-group subj-group-type="heading"><subject>Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Activity enhances dopaminergic long-duration response in Parkinson disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Jung Kang</surname>
<given-names>Un</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Auinger</surname>
<given-names>Peggy</given-names>
</name>
<degrees>MS</degrees>
</contrib>
<on-behalf-of>On behalf of the Parkinson Study Group ELLDOPA Investigators</on-behalf-of>
<aff>From the Department of Neurology (U.J.K.), The University of Chicago, Chicago, IL; and Department of Neurology (P.A.), Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY.</aff>
</contrib-group>
<contrib-group><contrib contrib-type="author"><name><surname>Fahn</surname>
<given-names>Stanley</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York, principal investigator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Oakes</surname>
<given-names>David</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y., chief biostatistician</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shoulson</surname>
<given-names>Ira</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y., co-principal investigator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kieburtz</surname>
<given-names>Karl</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff>University of Rochester, Rochester, N.Y., director, Clinical Trials Coordination Center</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rudolph</surname>
<given-names>Alice</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y., senior project coordinator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Marek</surname>
<given-names>Kenneth</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn., neuroimager</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Seibyl</surname>
<given-names>John</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn., neuroimager</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lang</surname>
<given-names>Anthony</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Olanow</surname>
<given-names>C. Warren</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tanner</surname>
<given-names>Caroline</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schifitto</surname>
<given-names>Giovanni</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y., medical monitor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Zhao</surname>
<given-names>Hongwei</given-names>
</name>
<degrees>ScD</degrees>
<aff>University of Rochester, Rochester, N.Y., biostatistician</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reyes</surname>
<given-names>Lydia</given-names>
</name>
<aff>Columbia University, New York, administrator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shinaman</surname>
<given-names>Aileen</given-names>
</name>
<degrees>JD</degrees>
<aff>University of Rochester, Rochester, N.Y., administrator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Comella</surname>
<given-names>Cynthia L.</given-names>
</name>
<degrees>MD</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Goetz</surname>
<given-names>Christopher</given-names>
</name>
<degrees>MD</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Blasucci</surname>
<given-names>Lucia M.</given-names>
</name>
<degrees>RN, CCRC</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Samanta</surname>
<given-names>Johan</given-names>
</name>
<degrees>MD</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stacy</surname>
<given-names>Mark</given-names>
</name>
<degrees>MD</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>Kelli</given-names>
</name>
<degrees>RN</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Harrigan</surname>
<given-names>Mary</given-names>
</name>
<degrees>RN, MN</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Greene</surname>
<given-names>Paul</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ford</surname>
<given-names>Blair</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Moskowitz</surname>
<given-names>Carol</given-names>
</name>
<degrees>ANP, MS</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Truong</surname>
<given-names>Daniel D.</given-names>
</name>
<degrees>MD</degrees>
<aff>Parkinson's and Movement Disorder Institute, Fountain Valley, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pathak</surname>
<given-names>Mayank</given-names>
</name>
<degrees>MD</degrees>
<aff>Parkinson's and Movement Disorder Institute, Fountain Valley, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jankovic</surname>
<given-names>Joseph</given-names>
</name>
<degrees>MD</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ondo</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Atassi</surname>
<given-names>Farah</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hunter</surname>
<given-names>Christine</given-names>
</name>
<degrees>RN</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jacques</surname>
<given-names>Carol</given-names>
</name>
<degrees>RN, ANP</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Friedman</surname>
<given-names>Joseph H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lannon</surname>
<given-names>Margaret</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Russell</surname>
<given-names>David S.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jennings</surname>
<given-names>Danna</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Fussell</surname>
<given-names>Barbara</given-names>
</name>
<degrees>RN</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Standaert</surname>
<given-names>David</given-names>
</name>
<degrees>MD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schwarzschild</surname>
<given-names>Michael A.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Growdon</surname>
<given-names>John H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tennis</surname>
<given-names>Marsha</given-names>
</name>
<degrees>RN</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gauthier</surname>
<given-names>Serge</given-names>
</name>
<degrees>MD</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Panisset</surname>
<given-names>Michel</given-names>
</name>
<degrees>MD</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hall</surname>
<given-names>Jean</given-names>
</name>
<degrees>RN</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gancher</surname>
<given-names>Stephen</given-names>
</name>
<degrees>MD</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hammerstad</surname>
<given-names>John P.</given-names>
</name>
<degrees>MD</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stone</surname>
<given-names>Claudia</given-names>
</name>
<degrees>RA</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Alexander-Brown</surname>
<given-names>Barbara</given-names>
</name>
<degrees>BS</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Factor</surname>
<given-names>Stewart A.</given-names>
</name>
<degrees>DO</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Molho</surname>
<given-names>Eric</given-names>
</name>
<degrees>MD</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Brown</surname>
<given-names>Diane</given-names>
</name>
<degrees>RN</degrees>
<aff>(deceased) Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Evans</surname>
<given-names>Sharon</given-names>
</name>
<degrees>LPN</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Clark</surname>
<given-names>Jeffrey</given-names>
</name>
<degrees>DO</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Manyam</surname>
<given-names>Bala</given-names>
</name>
<degrees>MD</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Simpson</surname>
<given-names>Patricia</given-names>
</name>
<degrees>MHSM, RN, CCRC</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wulbrecht</surname>
<given-names>Brian</given-names>
</name>
<degrees>BA, CCRP</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Whetteckey</surname>
<given-names>Jacqueline</given-names>
</name>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Martin</surname>
<given-names>Wayne</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Roberts</surname>
<given-names>Ted</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>King</surname>
<given-names>Pamela</given-names>
</name>
<degrees>BScN, RN</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hauser</surname>
<given-names>Robert</given-names>
</name>
<degrees>MD, MBA</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Zesiewicz</surname>
<given-names>Theresa</given-names>
</name>
<degrees>MD</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gauger</surname>
<given-names>Lisa</given-names>
</name>
<degrees>BA</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Trugman</surname>
<given-names>Joel</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wooten</surname>
<given-names>G. Frederick</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rost-Ruffner</surname>
<given-names>Elke</given-names>
</name>
<degrees>RN, BSN</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Perlmutter</surname>
<given-names>Joel</given-names>
</name>
<degrees>MD</degrees>
<aff>Washington University, St. Louis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Racette</surname>
<given-names>Brad A.</given-names>
</name>
<degrees>MD</degrees>
<aff>Washington University, St. Louis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Suchowersky</surname>
<given-names>Oksana</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ranawaya</surname>
<given-names>Ranjit</given-names>
</name>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wood</surname>
<given-names>Susan</given-names>
</name>
<degrees>RN</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pantella</surname>
<given-names>Carol</given-names>
</name>
<degrees>RN</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kurlan</surname>
<given-names>Roger</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Richard</surname>
<given-names>Irene</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pearson</surname>
<given-names>Nancy</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Caviness</surname>
<given-names>John N.</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Adler</surname>
<given-names>Charles</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lind</surname>
<given-names>Marlene</given-names>
</name>
<degrees>RN</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Simuni</surname>
<given-names>Tanya</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Siderowf</surname>
<given-names>Andrew</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Colcher</surname>
<given-names>Amy</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lloyd</surname>
<given-names>Mary</given-names>
</name>
<degrees>RN, PhD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Weiner</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shulman</surname>
<given-names>Lisa</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Koller</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lyons</surname>
<given-names>Kelly</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Feldman</surname>
<given-names>Robert G.</given-names>
</name>
<degrees>MD</degrees>
<aff>(deceased) Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Saint-Hilaire</surname>
<given-names>Marie H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ellias</surname>
<given-names>Samuel</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Thomas</surname>
<given-names>Cathi-Ann</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Juncos</surname>
<given-names>Jorge</given-names>
</name>
<degrees>MD</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Watts</surname>
<given-names>Ray</given-names>
</name>
<degrees>MD</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Partlow</surname>
<given-names>Anna</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tetrud</surname>
<given-names>James</given-names>
</name>
<degrees>MD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Togasaki</surname>
<given-names>Daniel M.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stewart</surname>
<given-names>Tracy</given-names>
</name>
<degrees>RN</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Mark</surname>
<given-names>Margery H.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sage</surname>
<given-names>Jacob I.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Caputo</surname>
<given-names>Debbie</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gould</surname>
<given-names>Harry</given-names>
</name>
<degrees>MD, PhD,</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rao</surname>
<given-names>Jayaraman</given-names>
</name>
<degrees>MD</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>McKendrick</surname>
<given-names>Ann</given-names>
</name>
<degrees>MSW</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Brin</surname>
<given-names>Mitchell</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Danisi</surname>
<given-names>Fabio</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Benabou</surname>
<given-names>Reina</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hubble</surname>
<given-names>Jean</given-names>
</name>
<degrees>MD</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Paulson</surname>
<given-names>George W.</given-names>
</name>
<degrees>MD</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reider</surname>
<given-names>Carson</given-names>
</name>
<degrees>MS</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Birnbaum</surname>
<given-names>Alex</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Miyasaki</surname>
<given-names>Janis</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Johnston</surname>
<given-names>Lisa</given-names>
</name>
<degrees>RN, BSCN, CNN</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>So</surname>
<given-names>Julie</given-names>
</name>
<degrees>RN</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pahwa</surname>
<given-names>Rajesh</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Kansas, Kansas City</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dubinsky</surname>
<given-names>Richard M.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Kansas, Kansas City</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wszolek</surname>
<given-names>Zbigniew</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Uitti</surname>
<given-names>Ryan</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Turk</surname>
<given-names>Margaret</given-names>
</name>
<degrees>RN</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tuite</surname>
<given-names>Paul</given-names>
</name>
<degrees>MD</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rottenberg</surname>
<given-names>David</given-names>
</name>
<degrees>MD</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hansen</surname>
<given-names>Joy</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ramos</surname>
<given-names>Serrano</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Puerto Rico, San Juan</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Waters</surname>
<given-names>Cheryl</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lew</surname>
<given-names>Mark</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Welsh</surname>
<given-names>Mickie</given-names>
</name>
<degrees>RN, DNS</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kawai</surname>
<given-names>Connie</given-names>
</name>
<degrees>RN, BSN, CCRC</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>O'Brien</surname>
<given-names>Christopher</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kumar</surname>
<given-names>Rajeev</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Seeberger</surname>
<given-names>Lauren</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Judd</surname>
<given-names>Deborah</given-names>
</name>
<degrees>RN</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Barclay</surname>
<given-names>C. Lynn</given-names>
</name>
<degrees>MD</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Grimes</surname>
<given-names>David A.</given-names>
</name>
<degrees>MD</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sutherland</surname>
<given-names>Laura</given-names>
</name>
<degrees>RN</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dawson</surname>
<given-names>Ted</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reich</surname>
<given-names>Stephen</given-names>
</name>
<degrees>MD</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dunlop</surname>
<given-names>Rebecca</given-names>
</name>
<degrees>RN</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Albin</surname>
<given-names>Roger</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Frey</surname>
<given-names>Kirk</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wernette</surname>
<given-names>Kristine</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
</contrib-group>
<contrib-group><contrib contrib-type="author"><name><surname>Fahn</surname>
<given-names>Stanley</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York, principal investigator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Oakes</surname>
<given-names>David</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y., chief biostatistician</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shoulson</surname>
<given-names>Ira</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y., co-principal investigator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kieburtz</surname>
<given-names>Karl</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff>University of Rochester, Rochester, N.Y., director, Clinical Trials Coordination Center</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rudolph</surname>
<given-names>Alice</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y., senior project coordinator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Marek</surname>
<given-names>Kenneth</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn., neuroimager</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Seibyl</surname>
<given-names>John</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn., neuroimager</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lang</surname>
<given-names>Anthony</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Olanow</surname>
<given-names>C. Warren</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tanner</surname>
<given-names>Caroline</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schifitto</surname>
<given-names>Giovanni</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y., medical monitor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Zhao</surname>
<given-names>Hongwei</given-names>
</name>
<degrees>ScD</degrees>
<aff>University of Rochester, Rochester, N.Y., biostatistician</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reyes</surname>
<given-names>Lydia</given-names>
</name>
<aff>Columbia University, New York, administrator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shinaman</surname>
<given-names>Aileen</given-names>
</name>
<degrees>JD</degrees>
<aff>University of Rochester, Rochester, N.Y., administrator</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Comella</surname>
<given-names>Cynthia L.</given-names>
</name>
<degrees>MD</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Goetz</surname>
<given-names>Christopher</given-names>
</name>
<degrees>MD</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Blasucci</surname>
<given-names>Lucia M.</given-names>
</name>
<degrees>RN, CCRC</degrees>
<aff>Rush-Presbyterian-St. Luke's Medical Center, Chicago</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Samanta</surname>
<given-names>Johan</given-names>
</name>
<degrees>MD</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stacy</surname>
<given-names>Mark</given-names>
</name>
<degrees>MD</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>Kelli</given-names>
</name>
<degrees>RN</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Harrigan</surname>
<given-names>Mary</given-names>
</name>
<degrees>RN, MN</degrees>
<aff>Barrow Neurological Institute, Phoenix, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Greene</surname>
<given-names>Paul</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ford</surname>
<given-names>Blair</given-names>
</name>
<degrees>MD</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Moskowitz</surname>
<given-names>Carol</given-names>
</name>
<degrees>ANP, MS</degrees>
<aff>Columbia University, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Truong</surname>
<given-names>Daniel D.</given-names>
</name>
<degrees>MD</degrees>
<aff>Parkinson's and Movement Disorder Institute, Fountain Valley, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pathak</surname>
<given-names>Mayank</given-names>
</name>
<degrees>MD</degrees>
<aff>Parkinson's and Movement Disorder Institute, Fountain Valley, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jankovic</surname>
<given-names>Joseph</given-names>
</name>
<degrees>MD</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ondo</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Atassi</surname>
<given-names>Farah</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hunter</surname>
<given-names>Christine</given-names>
</name>
<degrees>RN</degrees>
<aff>Baylor College of Medicine, Houston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jacques</surname>
<given-names>Carol</given-names>
</name>
<degrees>RN, ANP</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Friedman</surname>
<given-names>Joseph H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lannon</surname>
<given-names>Margaret</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>Brown University, Providence, R.I.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Russell</surname>
<given-names>David S.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jennings</surname>
<given-names>Danna</given-names>
</name>
<degrees>MD</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Fussell</surname>
<given-names>Barbara</given-names>
</name>
<degrees>RN</degrees>
<aff>Institute for Neurodegenerative Disorders, New Haven, Conn.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Standaert</surname>
<given-names>David</given-names>
</name>
<degrees>MD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schwarzschild</surname>
<given-names>Michael A.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Growdon</surname>
<given-names>John H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tennis</surname>
<given-names>Marsha</given-names>
</name>
<degrees>RN</degrees>
<aff>Massachusetts General Hospital, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gauthier</surname>
<given-names>Serge</given-names>
</name>
<degrees>MD</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Panisset</surname>
<given-names>Michel</given-names>
</name>
<degrees>MD</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hall</surname>
<given-names>Jean</given-names>
</name>
<degrees>RN</degrees>
<aff>McGill Centre for Studies in Aging, Verdun, Que., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gancher</surname>
<given-names>Stephen</given-names>
</name>
<degrees>MD</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hammerstad</surname>
<given-names>John P.</given-names>
</name>
<degrees>MD</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stone</surname>
<given-names>Claudia</given-names>
</name>
<degrees>RA</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Alexander-Brown</surname>
<given-names>Barbara</given-names>
</name>
<degrees>BS</degrees>
<aff>Oregon Health and Science University, Portland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Factor</surname>
<given-names>Stewart A.</given-names>
</name>
<degrees>DO</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Molho</surname>
<given-names>Eric</given-names>
</name>
<degrees>MD</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Brown</surname>
<given-names>Diane</given-names>
</name>
<degrees>RN</degrees>
<aff>(deceased) Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Evans</surname>
<given-names>Sharon</given-names>
</name>
<degrees>LPN</degrees>
<aff>Albany Medical College, Albany, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Clark</surname>
<given-names>Jeffrey</given-names>
</name>
<degrees>DO</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Manyam</surname>
<given-names>Bala</given-names>
</name>
<degrees>MD</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Simpson</surname>
<given-names>Patricia</given-names>
</name>
<degrees>MHSM, RN, CCRC</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wulbrecht</surname>
<given-names>Brian</given-names>
</name>
<degrees>BA, CCRP</degrees>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Whetteckey</surname>
<given-names>Jacqueline</given-names>
</name>
<aff>Scott and White Hospital-Texas A&M University, Temple</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Martin</surname>
<given-names>Wayne</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Roberts</surname>
<given-names>Ted</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>King</surname>
<given-names>Pamela</given-names>
</name>
<degrees>BScN, RN</degrees>
<aff>University of Alberta, Edmonton, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hauser</surname>
<given-names>Robert</given-names>
</name>
<degrees>MD, MBA</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Zesiewicz</surname>
<given-names>Theresa</given-names>
</name>
<degrees>MD</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gauger</surname>
<given-names>Lisa</given-names>
</name>
<degrees>BA</degrees>
<aff>University of South Florida</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Trugman</surname>
<given-names>Joel</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wooten</surname>
<given-names>G. Frederick</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rost-Ruffner</surname>
<given-names>Elke</given-names>
</name>
<degrees>RN, BSN</degrees>
<aff>University of Virginia, Charlottesville</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Perlmutter</surname>
<given-names>Joel</given-names>
</name>
<degrees>MD</degrees>
<aff>Washington University, St. Louis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Racette</surname>
<given-names>Brad A.</given-names>
</name>
<degrees>MD</degrees>
<aff>Washington University, St. Louis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Suchowersky</surname>
<given-names>Oksana</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ranawaya</surname>
<given-names>Ranjit</given-names>
</name>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wood</surname>
<given-names>Susan</given-names>
</name>
<degrees>RN</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pantella</surname>
<given-names>Carol</given-names>
</name>
<degrees>RN</degrees>
<aff>University of Calgary, Alta., Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kurlan</surname>
<given-names>Roger</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Richard</surname>
<given-names>Irene</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pearson</surname>
<given-names>Nancy</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Rochester, Rochester, N.Y.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Caviness</surname>
<given-names>John N.</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Adler</surname>
<given-names>Charles</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lind</surname>
<given-names>Marlene</given-names>
</name>
<degrees>RN</degrees>
<aff>Mayo Clinic, Scottsdale, Ariz.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Simuni</surname>
<given-names>Tanya</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Siderowf</surname>
<given-names>Andrew</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Colcher</surname>
<given-names>Amy</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lloyd</surname>
<given-names>Mary</given-names>
</name>
<degrees>RN, PhD</degrees>
<aff>University of Pennsylvania, Philadelphia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Weiner</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Shulman</surname>
<given-names>Lisa</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Koller</surname>
<given-names>William</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lyons</surname>
<given-names>Kelly</given-names>
</name>
<degrees>PhD</degrees>
<aff>University of Miami, Miami</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Feldman</surname>
<given-names>Robert G.</given-names>
</name>
<degrees>MD</degrees>
<aff>(deceased) Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Saint-Hilaire</surname>
<given-names>Marie H.</given-names>
</name>
<degrees>MD</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ellias</surname>
<given-names>Samuel</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Thomas</surname>
<given-names>Cathi-Ann</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>Boston University, Boston</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Juncos</surname>
<given-names>Jorge</given-names>
</name>
<degrees>MD</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Watts</surname>
<given-names>Ray</given-names>
</name>
<degrees>MD</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Partlow</surname>
<given-names>Anna</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>Emory University, Atlanta</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tetrud</surname>
<given-names>James</given-names>
</name>
<degrees>MD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Togasaki</surname>
<given-names>Daniel M.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Stewart</surname>
<given-names>Tracy</given-names>
</name>
<degrees>RN</degrees>
<aff>The Parkinson's Institute, Sunnyvale, Calif.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Mark</surname>
<given-names>Margery H.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sage</surname>
<given-names>Jacob I.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Caputo</surname>
<given-names>Debbie</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gould</surname>
<given-names>Harry</given-names>
</name>
<degrees>MD, PhD,</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rao</surname>
<given-names>Jayaraman</given-names>
</name>
<degrees>MD</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>McKendrick</surname>
<given-names>Ann</given-names>
</name>
<degrees>MSW</degrees>
<aff>Louisiana State University, New Orleans</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Brin</surname>
<given-names>Mitchell</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Danisi</surname>
<given-names>Fabio</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Benabou</surname>
<given-names>Reina</given-names>
</name>
<degrees>MD</degrees>
<aff>Mount Sinai School of Medicine, New York</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hubble</surname>
<given-names>Jean</given-names>
</name>
<degrees>MD</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Paulson</surname>
<given-names>George W.</given-names>
</name>
<degrees>MD</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reider</surname>
<given-names>Carson</given-names>
</name>
<degrees>MS</degrees>
<aff>Ohio State University, Columbus</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Birnbaum</surname>
<given-names>Alex</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Miyasaki</surname>
<given-names>Janis</given-names>
</name>
<degrees>MD</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Johnston</surname>
<given-names>Lisa</given-names>
</name>
<degrees>RN, BSCN, CNN</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>So</surname>
<given-names>Julie</given-names>
</name>
<degrees>RN</degrees>
<aff>Toronto Western Hospital, Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pahwa</surname>
<given-names>Rajesh</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Kansas, Kansas City</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dubinsky</surname>
<given-names>Richard M.</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Kansas, Kansas City</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wszolek</surname>
<given-names>Zbigniew</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Uitti</surname>
<given-names>Ryan</given-names>
</name>
<degrees>MD</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Turk</surname>
<given-names>Margaret</given-names>
</name>
<degrees>RN</degrees>
<aff>Mayo Clinic, Jacksonville, Fla.</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Tuite</surname>
<given-names>Paul</given-names>
</name>
<degrees>MD</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Rottenberg</surname>
<given-names>David</given-names>
</name>
<degrees>MD</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hansen</surname>
<given-names>Joy</given-names>
</name>
<degrees>RN, MSN</degrees>
<aff>Minneapolis Veterans Affairs Hospital, Minneapolis</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Ramos</surname>
<given-names>Serrano</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Puerto Rico, San Juan</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Waters</surname>
<given-names>Cheryl</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lew</surname>
<given-names>Mark</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Welsh</surname>
<given-names>Mickie</given-names>
</name>
<degrees>RN, DNS</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kawai</surname>
<given-names>Connie</given-names>
</name>
<degrees>RN, BSN, CCRC</degrees>
<aff>University of Southern California, Los Angeles</aff>
</contrib>
<contrib contrib-type="author"><name><surname>O'Brien</surname>
<given-names>Christopher</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kumar</surname>
<given-names>Rajeev</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Seeberger</surname>
<given-names>Lauren</given-names>
</name>
<degrees>MD</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Judd</surname>
<given-names>Deborah</given-names>
</name>
<degrees>RN</degrees>
<aff>Colorado Neurological Institute, Englewood</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Barclay</surname>
<given-names>C. Lynn</given-names>
</name>
<degrees>MD</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Grimes</surname>
<given-names>David A.</given-names>
</name>
<degrees>MD</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sutherland</surname>
<given-names>Laura</given-names>
</name>
<degrees>RN</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dawson</surname>
<given-names>Ted</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Reich</surname>
<given-names>Stephen</given-names>
</name>
<degrees>MD</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dunlop</surname>
<given-names>Rebecca</given-names>
</name>
<degrees>RN</degrees>
<aff>Johns Hopkins University, Baltimore</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Albin</surname>
<given-names>Roger</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Frey</surname>
<given-names>Kirk</given-names>
</name>
<degrees>MD</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Wernette</surname>
<given-names>Kristine</given-names>
</name>
<degrees>RN, MS</degrees>
<aff>University of Michigan, Ann Arbor</aff>
</contrib>
</contrib-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mendis</surname>
<given-names>Tilak</given-names>
</name>
<degrees>MD</degrees>
<aff>Ottawa Civic Hospital, Ottawa</aff>
</contrib>
</contrib-group>
<author-notes><fn fn-type="other"><p><italic>Study funding:</italic>
This project was supported by <funding-source>Parkinson Study Group</funding-source>
/<funding-source>Parkinson Disease Foundation</funding-source>
data-mining grant (U.J.K., P.A.). U.J.K. was also supported in part by <funding-source>NIH</funding-source>
<award-id>R01 NS064865</award-id>
and <funding-source>American Parkinson Disease Association Advanced Center for Research</funding-source>
.</p>
</fn>
<corresp>Correspondence & reprint requests to Dr. Kang: <email>unkang@uchicago.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>10</day>
<month>4</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>10</day>
<month>4</month>
<year>2013</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
. </pmc-comment>
<volume>78</volume>
<issue>15</issue>
<fpage>1146</fpage>
<lpage>1149</lpage>
<history><date date-type="received"><day>25</day>
<month>7</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>17</day>
<month>11</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2012 by AAN Enterprises, Inc.</copyright-statement>
<copyright-year>2012</copyright-year>
<copyright-holder>AAN Enterprises, Inc.</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="znl01512001146.pdf"></self-uri>
<abstract><sec><title>Objective:</title>
<p>We tested the hypothesis that dopamine-dependent motor learning mechanism underlies the long-duration response to levodopa in Parkinson disease (PD) based on our studies in a mouse model. By data-mining the motor task performance in dominant and nondominant hands of the subjects in a double-blind randomized trial of levodopa therapy, the effects of activity and dopamine therapy were examined.</p>
</sec>
<sec><title>Methods:</title>
<p>We data-mined the Earlier versus Later Levodopa Therapy in Parkinson's Disease (ELLDOPA) study published in 2005 and performed statistical analysis comparing the effects of levodopa and dominance of handedness over 42 weeks.</p>
</sec>
<sec><title>Results:</title>
<p>The mean change in finger-tapping counts from baseline before the initiation of therapy to predose at 9 weeks and 40 weeks increased more in the dominant compared to nondominant hand in levodopa-treated subjects in a dose-dependent fashion. There was no significant difference in dominant vs nondominant hands in the placebo group. The short-duration response assessed by the difference of postdose performance compared to predose performance at the same visit did not show any significant difference between dominant vs nondominant hands.</p>
</sec>
<sec><title>Conclusions:</title>
<p>Active use of the dominant hand and dopamine replacement therapy produces synergistic effect on long-lasting motor task performance during “off” medication state. Such effect was confined to dopamine-responsive symptoms and not seen in dopamine-resistant symptoms such as gait and balance. We propose that long-lasting motor learning facilitated by activity and dopamine is a form of disease modification that is often seen in trials of medications that have symptomatic effects.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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