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December 1972

Levodopa Therapy Effects on Natural History of Parkinsonism

Arch Neurol. 1972;27(6):481-485. doi:10.1001/archneur.1972.00490180017005

A quantitative functional evaluation, the motility index, was used as the principal measure of a patient's status in the study of levodopa therapy in the long-term treatment of parkinsonism. This study had three objectives: (1) to determine whether, after initial rapid improvement, patients continued to improve more slowly, level off, or decline over the long term; (2) to determine the effect of temporary withdrawal of the drug; and (3) to infer from the preceding whether levodopa alters the progression of parkinsonism. Sixtyeight patients who had been on a regimen of levodopa for at least one year maintained their initial improvement for over 30 months. Forty of these patients were temporarily placed on a placebo. Most of them experienced a rapid return of parkinsonian symptoms and signs. The results of the study suggest that a period of levodopa withdrawal can be beneficial and that the usual tendency for progression in parkinsonism may have been altered.