title: Treatment in early Parkinson's disease: the Norwegian ParkWest study.
abstract: OBJECTIVE
  There are limited data on treatment effect in early and drug-naïve Parkinson's disease (PD) outside of clinical trials. We sought to review the treatment effects on motor symptoms in early, unselected PD patients.
  
  
  METHODS
  We included 183 drug-naïve patients from a longitudinal cohort (The Norwegian ParkWest study). At the time of diagnosis, motor symptoms were assessed and rated. Treatment was unrestricted, aimed at treating each patient optimally. Patients were reassessed after 12 months, and then grouped according to treatment: No dopaminergic treatment (NDT), dopamine agonists (DA) or levodopa. All strategies could be combined with monoamine oxidase B inhibitors.
  
  
  RESULTS
  In general, the chosen treatment was coherent with current practice. During follow-up, patients given NDT (n = 40) had unaltered clinical motor symptoms, as opposed to improvement in the DA- and levodopa-treated patients (n = 140). The overall improvement in these two groups was fairly similar, but axial symptoms did not improve in levodopa-treated patients as opposed to the younger DA-treated patients.
  
  
  CONCLUSIONS
  Twelve months after the diagnosis, motor symptoms in approximately one-fifth of PD patients remained clinically stable. Tremor, bradykinesia and rigidity improved in the dopaminergic-treated patients. Axial symptoms were more treatment resistant, and the different symptomatic effects found between treatment strategies may be age related.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway. oystein.tveiten@helse-bergen.no
authors.forename: O V
authors.initials: OV
authors.lastname: Tveiten
authors.forename: G O
authors.initials: GO
authors.lastname: Skeie
authors.forename: K
authors.initials: K
authors.lastname: Haugarvoll
authors.forename: B
authors.initials: B
authors.lastname: Müller
authors.forename: J P
authors.initials: JP
authors.lastname: Larsen
authors.forename: O B
authors.initials: OB
authors.lastname: Tysnes
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009664:Norway; D010300:Parkinson Disease / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents; D007980:Levodopa