Advantages and limitations in the assessment of neuroprotective treatment of Parkinson's disease by functional imaging
Thobois, S.; Broussolle, E.; Remy, P.
Revue Neurologique (Paris) 161(4): 385-393
2005
ISSN/ISBN: 0035-3787 PMID: 15924074 Document Number: 585195
Advantages and limitations in the assessement of neuroprotective treatment of Parkinson's disease by functional imaging. S. Thobois, E Broussolle, P. Remy, Rev Neurol (Paris) 2005; 161: 4, 385-393Introduction. The development of neuroprotective strategies is a crucial issue for Parkinson's disease, since up to now only symptomatic therapies are available. The clirical evaluation of neuroprotective drugs is difficult considering the long-term effect of anti-parkinsonian medication that nearly make impossible accurate measurement of the "true" clinical stage of the disease in the early years of progression.Background. Two recent functional imaging studies (CALM-PD and REAL-PET) using positron emission tomography (PET) or single photon emission computed tomography (SPECT), suggest that dopamine agonist may have a neuroprotective effect compared to L-Dopa.Conclusion. These results are still controversial, notably because of the lack of clinical-imaging correlations, the absence of a placebo group and some important methodological considerations. Nevertheless, these studies are encouraging and give some arguments for the potential neuroprotective role of dopamine agonists. The aim of this work is first to present the pros and cons of these studies and second to propose guidelines in order to improve the design and methodology for future studies designed to assess the neuroprotective properties of new drugs in Parkinson's disease.