The natural history of treated PD in an incident, community-based cohort: does the future begin?

Advances in our understanding of the genetics, epidemiology, clinical phenotype and pathological progression of Parkinson’s disease (PD) have ushered in an era in which researchers are increasingly looking for therapies that modify (prevent or delay) PD course. Drugs like levodopa, selegiline and rasagiline, which are known to ameliorate the core motor symptoms of PD, have been tested for a possible disease-modifying effect,1–3 and new putative neuroprotective therapies could soon be available.

In order to accurately test neuroprotective effects, drugs need to be challenged with markers of disease progression. To date, data from putative biomarkers assessed in body fluids are limited and inconclusive, structural imaging does not add relevant information to our knowledge and imaging techniques that enable assessment of the nigrostriatal dopaminergic system (like dopamine transporter single photon emission CT) might not sufficiently mirror disease progression owing to possible confounding by dopaminergic medication.<cross-ref…

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