(discovered the following comment on another site. This is also written by Dr. Okun)
http://www.jwatch.org/na31372/2013/0...europrotective

Comment

Dopamine agonists have been falling out of favor among movement disorder specialists because of the adverse effect of impulse control disorders and other effects such as nausea, orthostasis, edema, and sleep attacks. The controversial notion that dopamine agonists are neuroprotective or could modify disease progression, although bolstered by animal data, has never been put to the test. This current study adds important clinical and imaging evidence against the notion that pramipexole is neuroprotective in patients with PD. These findings likely apply to other dopamine agonists. In the imaging substudy, 14 patients (9%) had no evidence of dopamine deficiency on the scan, a condition known as a SWEDD (scan without evidence of dopamine deficiency). Although the SWEDD rate was lower than in other published studies of early PD, 10% to 20% of patients with early PD symptoms may not progress to a true diagnosis of PD. Thus, the current findings more accurately reflect the clinical population. Neurologists should make their patients aware of the lack of clinical evidence supporting dopamine agonist use as a neuroprotective therapy and should follow an early PD diagnosis carefully to confirm disease progression.

Editor Disclosures at Time of Publication
Citation(s):

Schapira AHV et al. Pramipexole in patients with early Parkinson's disease (PROUD): A randomised delayed-start trial. Lancet Neurol 2013 May 31; [e-pub ahead of print]. (http://dx.doi.org/10.1016/S1474-4422(13)70117-0)
- See more at: http://www.jwatch.org/na31372/2013/0....VduHctgQ.dpuf