The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Levodopa and the progression of Parkinson's disease.
Despite the known benefit of levodopa in reducing the symptoms of Parkinson's disease, concern has been expressed that its use might hasten neurodegeneration. This study assessed the effect of levodopa on the rate of progression of Parkinson's disease. ⋯ The clinical data suggest that levodopa either slows the progression of Parkinson's disease or has a prolonged effect on the symptoms of the disease. In contrast, the neuroimaging data suggest either that levodopa accelerates the loss of nigrostriatal dopamine nerve terminals or that its pharmacologic effects modify the dopamine transporter. The potential long-term effects of levodopa on Parkinson's disease remain uncertain.
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Historical Article
Images in clinical medicine. The tale of Phineas Gage, digitally remastered.