0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Progression of Parkinson Disease:  Are We Making Progress in Charting the Course?

Joseph Jankovic, MD
Arch Neurol. 2005;62(3):351-352. doi:10.1001/archneur.62.3.351.
Text Size: A A A
Published online

Extract

While progressive motor and nonmotor decline is the expected natural course of Parkinson disease (PD), there is a remarkable paucity of data on what determines the rate of progression before and after the onset of symptoms. Using serial fluorodopa F 18 ([18F]fluorodopa) positron emission tomography (PET) in a prospective, longitudinal study of 31 patients with PD observed for more than 5 years, Hilker et al1 found an annual decline in striatal [18F]fluorodopa ranging from 4.4% (caudate) to 6.3% (putamen). This is similar to other longitudinal studies of PD progression, using imaging ligands that either measure dopamine metabolism ([18F]fluorodopa PET) or target dopamine transporter (β-carboxymethyoxy-3-β-[4-iodophenyl] tropane single-photon emission computed tomography), demonstrating an annualized rate of reduction in these striatal markers of about 4% to 13% in patients with PD compared with 0% to 2.5% change in healthy controls.25 These imaging studies are consistent with pathological studies showing that the rate of nigral degeneration in patients with PD is 8- to 10-fold higher than that in healthy age-matched controls.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.

Hypothetical dopaminergic and nondopaminergic progression and compensatory mechanisms postulated for Parkinson disease (PD) and other presynaptic (congenital or genetic) parkinsonian disorders. DA indicates dopamine; SN, substantia nigra.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 27

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
Make the Diagnosis: Parkinsonism

The Rational Clinical Examination
Original Article: Does This Patient Have Parkinson Disease?

brightcove.createExperiences();