Jury Still Out on Whether Levodopa Is Neurotoxic or Neuroprotective

Clinical evidence from the ELLDOPA trial argues against neurotoxicity, but imaging data suggest otherwise.

These researchers took on the daunting task of answering the clinically relevant question of whether levodopa is neurotoxic or neuroprotective in Parkinson disease (PD).

To answer this question, they conducted the Parkinson Study Group trial, ELLDOPA, in which 361 patients diagnosed with PD within the previous 2 years who did not require symptomatic therapy were randomized to receive 50 mg, 100 mg, or 200 mg of levodopa or placebo three times a day. Dose escalation lasted 9 weeks, followed by 40 weeks of treatment, a 3-day withdrawal period, and a 2-week washout period. The main outcome measure was total Unified Parkinson Disease Rating Scale (UPDRS) score at 42 weeks. The investigators also used β-CIT SPECT imaging to examine the change in …

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)