Neuroprotection in Parkinson disease - Mysteries, myths, and misconceptions
Neuroprotection in Parkinson disease - Mysteries, myths, and misconceptions
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DOI：
10.1001/jama.291.3.358
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发表时间：
2004-01-21
影响因子：
120.7
通讯作者：
Olanow, CW
中科院分区：
文献类型：
--
作者：
Schapira, AHV;Olanow, CW
帕金森氏病是一种与年龄相关的神经退行性疾病，每年约有1。在美国有100万人。目前的治疗方法可以有效控制症状，特别是在疾病的早期阶段，但大多数患者在长期治疗后会出现运动并发症，并且出现姿势不稳定、衰竭和痴呆等特征，这些特征是现有药物无法充分控制的。因此，迫切需要可能减缓、停止或逆转疾病进展的神经保护疗法。虽然许多药物在实验室研究中看起来很有希望，但为临床试验选择不受研究干预症状影响的临床终点一直很困难。最近，神经成像终点被用作。疾病进展的生物标志物，但也有人担心它们可能受到所使用药物的调节作用的影响。我们回顾了旨在检测帕金森病神经保护的临床试验，并解决了围绕这些研究解释的争议。
Parkinson disease is an age-related neurodegenerative disease that affects approximately 1. million persons in the United States. Current therapies provide effective control of symptoms, particularly in the early stages of the disease, but most patients develop motor complications with long-term treatment, and features develop such as postural instability, failing, and dementia that are not adequately controlled with existing medications. Accordingly, neuroprotective therapy that might slow, stop, or reverse disease progression is urgently needed. While many agents appear to be promising based on laboratory studies, selecting clinical end points for clinical trials that are not confounded by symptomatic effects of the study intervention has been difficult. More recently, neuroimaging end points have been used as. biomarkers of disease progression, but again there are concerns that they may be influenced by regulatory effects of the drugs used. We review clinical trials aimed at detecting neuroprotection in Parkinson disease and address the controversies surrounding the interpretation of these studies.