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Published online before print April 2, 2006, doi:10.1212/01.wnl.0000206363.57955.1b)
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Received August 17, 2005
Accepted January 19, 2006

Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology

O. Suchowersky MD, G. Gronseth MD, J. Perlmutter MD, S. Reich MD, T. Zesiewicz MD, and W. J. Weiner MD

From University of Calgary (O.S.), Calgary, AB, Canada; University of Kansas (G.G.), Kansas City; Division of Radiation Sciences (J.P.), Saint Louis, MO; University of Maryland Hospital (S.R.), Baltimore; Movement Disorder Center (T.Z.), Tampa, FL; and University of Maryland School of Medicine (W.J.W.), Baltimore.


Abstract-- Objective: To define key issues in the management of Parkinson disease (PD) relating to neuroprotective strategies and alternative treatments, and to make evidence-based treatment recommendations. Methods: Two clinical questions were identified. 1) In a patient diagnosed with PD, are there any therapies that can slow disease progression? 2) Are there any nonstandard pharmacologic or nonpharmacologic therapies that have been shown to improve motor function in PD? Articles were classified according to a four-tiered level of evidence scheme. Recommendations were based on the evidence. Results and conclusions: 1. Levodopa does not appear to accelerate disease progression. 2. No treatment has been shown to be neuroprotective. 3. There is no evidence that vitamin or food additives can improve motor function in PD. 4. Exercise may be helpful in improving motor function. 5. Speech therapy may be helpful in improving speech volume. 6. No manual therapy has been shown to be helpful in the treatment of motor symptoms, although studies in this area are limited. Further studies using a rigorous scientific method are needed to determine efficacy of alternative therapies.




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Reply from the authors
Oksana Suchowersky, et al.
Neurology Online, 15 Aug 2006 [Full text]
Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease
Erwin B. Montgomery
Neurology Online, 15 Aug 2006 [Full text]

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