title: Practical importance of neuroprotection in Parkinson's disease.
abstract: Consensus could be reached that there is overwhelming evidence of preclinical neuroprotection. However, the evidence of neuroprotection/neurorescue under clinical conditions is limited. Lessons from clinical trials designed to show neuroprotection (selegiline, amantadine, dopamine agonists) demonstrate that with the drugs available neuroprotection/neurorescue has to start as early as possible. A PET-controlled clinical trial with ropinirole shows that there seems to be a good chance for neuroprotection in the early phase of Parkinson's disease in patients treated from the very beginning of the disease while there is no such benefit in patients with a late start of a neuroprotective therapeutic strategy. Also long-term clinical neuroprotection cannot be reached. Complicating factors to demonstrate clinical neuroprotection are discussed.
authors.affiliation: Clinical Neurochemistry, Clinic and Policlinic of Psychiatry and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany. peter.riederer@mail.uni-wuerzburg.de
authors.forename: P
authors.initials: P
authors.lastname: Riederer
authors.forename: G
authors.initials: G
authors.lastname: Gille
authors.forename: T
authors.initials: T
authors.lastname: Müller
authors.forename: H
authors.initials: H
authors.lastname: Przuntek
authors.forename: H
authors.initials: H
authors.lastname: Reichmann
authors.forename: O
authors.initials: O
authors.lastname: Riess
authors.forename: A
authors.initials: A
authors.lastname: Schwartz
authors.forename: J
authors.initials: J
authors.lastname: Schwarz
authors.forename: T
authors.initials: T
authors.lastname: Vogt
mesh_terms: D000547:Amantadine / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000628:therapy*; D012642:Selegiline / Q000627:therapeutic use
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007211:Indoles; D018696:Neuroprotective Agents; C046649:ropinirole; D012642:Selegiline; D000547:Amantadine