Movement Disorders (revue)

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Sydney multicenter study of Parkinson's disease : Non-L-dopa-responsive problems dominate at 15 years

Identifieur interne : 001F59 ( PascalFrancis/Corpus ); précédent : 001F58; suivant : 001F60

Sydney multicenter study of Parkinson's disease : Non-L-dopa-responsive problems dominate at 15 years

Auteurs : Mariese A. Hely ; John G. L. Morris ; Wayne G. J. Reid ; Robert Trafficante

Source :

RBID : Pascal:05-0151001

Descripteurs français

English descriptors

Abstract

One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicentre Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A08 01  1  ENG  @1 Sydney multicenter study of Parkinson's disease : Non-L-dopa-responsive problems dominate at 15 years
A11 01  1    @1 HELY (Mariese A.)
A11 02  1    @1 MORRIS (John G. L.)
A11 03  1    @1 REID (Wayne G. J.)
A11 04  1    @1 TRAFFICANTE (Robert)
A14 01      @1 Department of Neurology, Westmead Hospital @2 Westmead New South Wales @3 AUS @Z 1 aut. @Z 2 aut. @Z 3 aut.
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A43 01      @1 INIST @2 20953 @5 354000126378730080
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A47 01  1    @0 05-0151001
A60       @1 P
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C01 01    ENG  @0 One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicentre Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.
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N21       @1 101
N44 01      @1 OTO
N82       @1 OTO

Format Inist (serveur)

NO : PASCAL 05-0151001 INIST
ET : Sydney multicenter study of Parkinson's disease : Non-L-dopa-responsive problems dominate at 15 years
AU : HELY (Mariese A.); MORRIS (John G. L.); REID (Wayne G. J.); TRAFFICANTE (Robert)
AF : Department of Neurology, Westmead Hospital/Westmead New South Wales/Australie (1 aut., 2 aut., 3 aut.); Covance Pty Ltd/Ainslie, Australian Capital Territory/Australie (4 aut.)
DT : Publication en série; Niveau analytique
SO : Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2005; Vol. 20; No. 2; Pp. 190-199; Bibl. 67 ref.
LA : Anglais
EA : One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicentre Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.
CC : 002B17; 002B17G; 002B17A03
FD : Système nerveux pathologie; Etude multicentrique; Lévodopa; Parkinson maladie
FG : Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Antiparkinsonien
ED : Nervous system diseases; Multicenter study; Levodopa; Parkinson disease
EG : Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Antiparkinson agent
SD : Sistema nervioso patología; Estudio multicéntrico; Levodopa; Parkinson enfermedad
LO : INIST-20953.354000126378730080
ID : 05-0151001

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Pascal:05-0151001

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<NO>PASCAL 05-0151001 INIST</NO>
<ET>Sydney multicenter study of Parkinson's disease : Non-L-dopa-responsive problems dominate at 15 years</ET>
<AU>HELY (Mariese A.); MORRIS (John G. L.); REID (Wayne G. J.); TRAFFICANTE (Robert)</AU>
<AF>Department of Neurology, Westmead Hospital/Westmead New South Wales/Australie (1 aut., 2 aut., 3 aut.); Covance Pty Ltd/Ainslie, Australian Capital Territory/Australie (4 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2005; Vol. 20; No. 2; Pp. 190-199; Bibl. 67 ref.</SO>
<LA>Anglais</LA>
<EA>One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicentre Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.</EA>
<CC>002B17; 002B17G; 002B17A03</CC>
<FD>Système nerveux pathologie; Etude multicentrique; Lévodopa; Parkinson maladie</FD>
<FG>Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Antiparkinsonien</FG>
<ED>Nervous system diseases; Multicenter study; Levodopa; Parkinson disease</ED>
<EG>Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Antiparkinson agent</EG>
<SD>Sistema nervioso patología; Estudio multicéntrico; Levodopa; Parkinson enfermedad</SD>
<LO>INIST-20953.354000126378730080</LO>
<ID>05-0151001</ID>
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