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This Article Full Text Full Text (PDF) CME: Take the course for this article: Volume 66, Number 7, April 11, 2006 Data Supplement Data Supplement Spanish Translation A correction has been published All Versions of this Article: 01.wnl.0000206363.57955.1bv1 66/7/976    most recent Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Suchowersky, O. Articles by Weiner, W. J. Search for Related Content PubMed PubMed Citation Articles by Suchowersky, O. Articles by Weiner, W. J. Related Collections Parkinson's disease/Parkinsonism

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

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.

Address correspondence and reprint requests to the American Academy of Neurology, 1080 Montreal Avenue, Saint Paul, MN 55116.

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.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 11 issue to find the title link for this article.

Editorial, see page 966

See also pages 968, 983, and 996

This article was previously published in electronic format as an Expedited E-Pub at www.neurology.org.

Quality Standards Subcommittee members are listed in appendix E-3 on the Neurology Web site at www.neurology.org.

Approved by QSS on July 30, 2005; Practice Committee December 15, 2005; Board of Directors February 23, 2006.

Endorsed by the National Parkinson Foundation and the Parkinson’s Disease Foundation.

Disclosures are provided after the text.

Received August 17, 2005. Accepted in final form January 19, 2006.

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