title: Parkinson's disease severity and use of dopaminergic medications.
abstract: BACKGROUND
  The effects of dopaminergic therapy in parkinson's disease (PD) can vary depending on the class of medication selected.
  
  
  OBJECTIVE
  The aim of this post hoc study was to determine if the class of dopaminergic therapy correlated with disease severity in persons with early, treated PD.
  
  
  METHODS
  A non-parametric global statistical test (GST) was used to assess the status of participants treated with dopamine agonist (DA) monotherapy, levodopa (LD) monotherapy or combined LD and DA therapy on multiple PD outcomes encompassing motor, cognitive, psychiatric and autonomic function, as well as disability and quality of life.
  
  
  RESULTS
  The outcomes measured at the beginning of the study showed lower disease burden for participants on initial DA monotherapy compared to those taking combined LD and DA therapy after controlling for age, education, taking cog-meds and amantadine.
  
  
  CONCLUSIONS
  This observation suggests that clinicians treating early PD patients favor combined LD and DA therapy in patients with more disabling features over DA monotherapy. As such, studies of PD progression in treated PD patients may be affected by the class of symptomatic dopaminergic therapy.
authors.affiliation: Department of Neurology, Vanderbilt University, 1161 21st Ave South, A-0118, Nashville, TN 37232, USA. Electronic address: john.y.fang@vanderbilt.edu.
authors.forename: John Y
authors.initials: JY
authors.lastname: Fang
authors.affiliation: UTHealth, The University of Texas School of Public Health, Austin Regional Campus, University of Texas Administration Building (UTA), 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Pérez
authors.affiliation: Department of Neurology, University of California at San Francisco, 400 Parnassus Ave, Box 0348, San Francisco, CA 94143, USA.
authors.forename: Chadwick W
authors.initials: CW
authors.lastname: Christine
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Academic Office 1, Mail Stop B-185, 12631 East 17th Avenue, Aurora, CO 80045, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Leehey
authors.affiliation: Department of Neurology, School of Medicine, University of California at San Francisco, 505 Parnassus Ave, Box 0114, San Francisco, CA 94143-0114, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Aminoff
authors.affiliation: Department of Neurological Sciences, University of Vermont College of Medicine, 1 South Prospect Street, Burlington, VT 05401, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Boyd
authors.affiliation: Movement and Cognitive Disorders Center, Department of Neurology, Medical College of Georgia, Georgia Regents University, 1429 Harper Street, HF-1154, Augusta, GA 30912, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Morgan
authors.affiliation: Barrow Neurological Institute, 240 W Thomas Road, Suite 301, Phoenix, AZ 85013, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Dhall
authors.affiliation: Department of Neurology, University of Alabama at Birmingham and The Birmingham VA Medical Center, 1720 2nd Avenue South, Birmingham, AL 35294, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Nicholas
authors.affiliation: Department of Neurology, State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA; Department of Ophthalmology, State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA.
authors.forename: Ivan
authors.initials: I
authors.lastname: Bodis-Wollner
authors.affiliation: Department of Neurology, LSU Health Sciences Center in Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Zweig
authors.affiliation: Department of Neurology, Michigan State University, 804 Service Rd, Room A217, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Goudreau
mesh_terms: D015259:Dopamine Agents / Q000145:classification / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy / Q000503:physiopathology; D007980:Levodopa / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D015337:Multicenter Studies as Topic; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D015259:Dopamine Agents; D018491:Dopamine Agonists; D007980:Levodopa
keywords: Clinical trial; Cognition; Disability; Dopamine agonist; Levodopa; Parkinson's disease