Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Review Eur Neurol 2009;61:206–215 DOI: 10.1159/000197104 Treatment of Early Parkinson’s Disease Part 2 Tanya Simuni a Kelly E. Lyons c Rajesh Pahwa c Robert A. Hauser d Cynthia Comella b Lawrence Elmer e Daniel Weintraub f a Parkinson’s Disease and Movement Disorders Center and Department of Neurology, Northwestern University, and b Department of Neurological Sciences, Rush University Medical Center, Chicago, Ill., c Parkinson Disease and Movement Disorder Center and Department of Neurology, University of Kansas Medical Center, Kansas City, Kans., d Parkinson’s Disease and Movement Disorders Center and Departments of Neurology, Pharmacology and Experimental Therapeutics, University of South Florida, Tampa, Fla., e Center for Neurological Disorders and Department of Neurology, University of Toledo, Toledo, Ohio, and f Departments of Psychiatry and Neurology, University of Pennsylvania, Philadelphia, Pa., USA however, the review did not include the management of early PD since there were no major changes since the last guidelines. Evidence-based treatment guidelines for ear- ly PD were published by the American Academy of Neu- rology in 2002 [4] and the Movement Disorder Society in 2005 [5], but since then new drugs and formulations have become available for the management of the disease. PD is a multifaceted disorder comprised of both motor and non-motor symptoms at all stages of the disease. This review seeks to integrate data from the newest treatment options with data from established therapies, so as to pro- vide an up-to-date evidence-based reference for clini- cians treating early PD. The article is presented in 2 parts: a review of the efficacy and safety of treatments for PD motor symptoms (part 1) and a review of key clinical tri- als examining potential neuroprotective therapies for PD and non-motor manifestations of PD (part 2). The follow- ing text is part 2. Beyond Symptomatic Therapy: Neuroprotection Studies in PD Neuroprotective therapies are interventions that pro- duce enduring benefits by favorably influencing the un- derlying etiology or pathogenesis of neurodegenerative Key Words Parkinson’s disease  Dopamine agonists  Monoamine oxidase B inhibitors  Levodopa Abstract The management of early Parkinson’s disease (PD) involves the treatment of motor symptoms, and, increasingly, non- motor symptoms. Given the fast pace of clinical research in PD, clinicians are faced with the challenge of integrating the latest findings into the ongoing care of individual PD pa- tients. Part 1 of this 2-part article reviews efficacy and safety data for the newest PD treatment options, as well as for es- tablished therapies. Part 2 of the article, presented here, re- views key data relevant to the assessment of potential neu- roprotective therapies and the treatment of non-motor symptoms. Copyright © 2009 S. Karger AG, Basel Introduction The treatment options for Parkinson’s disease (PD) are rapidly expanding. The American Academy of Neurolo- gy published evidence-based practice parameters of se- lected topics in the management of PD in 2006 [1–3]; Received: May 28, 2008 Accepted: September 25, 2008 Published online: January 29, 2009 Tanya Simuni, MD Northwestern University 710 North Lake Shore Drive, 1126 Chicago, IL 60611 (USA) Tel. +1 312 503 2970, Fax +1 312 908 5073, E-Mail tsimuni@nmff.org © 2009 S. Karger AG, Basel 0014–3022/09/0614–0206$26.00/0 Accessible online at: www.karger.com/ene