Abstract

Levodopa reduces the symptoms of Parkinson’s disease, but might it hasten neurodegeneration? A randomized placebo controlled trial evaluated 361 patients with early Parkinson’s disease who received varying amounts of carbidopa-levodopa or a matching placebo for 40 weeks after which treatment was withdrawn for 2 weeks. The severity of parkinsonism increased more in the placebo group than in those receiving levodopa. Interestingly, neuroimaging studies done to assess striatal dopamine transporter density suggested that levodopa perhaps accelerates the loss of nigrostriatal dopamine nerve terminals. These contrasting results mean that our question remains unanswered.

New England Journal of Medicine 2004, 351, 2498–508.

Research done on over 100 patients and controls in Rochester, USA and Japan identifies NMO-IgG as a specific serum marker autoantibody of neuromyelitis optica (Devic’s disease). This condition needs to be differentiated from multiple sclerosis for several reasons but also because the treatment for the two can vary. Immunosuppressive drugs