[Recent advances in Parkinson disease].
OBJECTIVE
To evaluate the latest advances in the diagnosis and symptomatic pharmacological treatment of patients with Parkinson's disease at different stages.


METHODS
In this article we summarize the criteria for clinical diagnosis of Parkinson's disease based on recent clinico-pathological studies. We evaluate the different therapeutic options at early and late stages of the illness in view of the results of recent, controlled, double-blind studies in which the efficacy of new dopaminergic agonists (carbergolin, pramipexol and ropinirol) and catechol-O-methyl-transferase enzyme inhibitors (COMT; entacapone and tolcapone) are compared with placebo and with established treatments (e.g. levodopa and bromocryptin).


CONCLUSIONS
Levodopa is still the most important advance yet made in the treatment of Parkinson's disease, but new dopaminergic agonists and COMT inhibitors are useful additions to the possibilities available for the treatment of early and late stages of the illness and may be included in modern guidelines for treatment.
Litvan
I
I
Unidad de Neurofarmacología, Henry M. Jackson Foundation, Bethesda, MD, USA. litvan1@helix.nih.gov
D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001577:Benzophenones / Q000494:pharmacology / Q000627:therapeutic use*; D052160:Benzothiazoles; D000077465:Cabergoline; D002396:Catechols / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004873:Ergolines / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use*; D009570:Nitriles; D009596:Nitrophenols; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy*; D000077487:Pramipexole; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077867:Tolcapone
D000978:Antiparkinson Agents; D001577:Benzophenones; D052160:Benzothiazoles; D002396:Catechols; D004873:Ergolines; D007211:Indoles; D009570:Nitriles; D009596:Nitrophenols; D013844:Thiazoles; C046649:ropinirole; C071192:entacapone; D000077487:Pramipexole; D000077867:Tolcapone; D000077465:Cabergoline