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July 17, 2002

Brain Imaging to Assess the Effects of Dopamine Agonists on Progression of Parkinson Disease

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(3):311-313. doi:10.1001/jama.288.3.311

To the Editor: I have 2 concerns about the study of Dr Marek and colleagues.1 First, the group in this study (which is a subset of the authors' larger trial) shows an atypically slow rate of clinical progression. The author's earlier publication2 reports a mean change in total Unified Parkinson Disease Rating Scale (UPDRS) of 9.2 for the entire levodopa group (n = 150) and 4.5 for the entire pramipexole group (n = 151) at 23.5 months. However, for the subset in the current study the respective data are –3.3 for the levodopa group and 0.9 for the pramipexole group at 22 months, and 4.0 and 4.1 at 46 months (n = 32/33). The results can therefore only be considered relevant to patients with very slowly progressing PD.