PT  - JOURNAL ARTICLE
AU  - Asimakopoulos, P
AU  - Caslake, R
AU  - Harris, C E
AU  - Gordon, J C
AU  - Taylor, K S M
AU  - Counsell, C
TI  - Changes in quality of life in people with Parkinson’s disease left untreated at diagnosis
AID  - 10.1136/jnnp.2007.137190
DP  - 2008 Jun 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 716--718
VI  - 79
IP  - 6
4099  - http://jnnp.bmj.com/content/79/6/716.short
4100  - http://jnnp.bmj.com/content/79/6/716.full
SO  - J Neurol Neurosurg Psychiatry2008 Jun 01; 79
AB  - Background: The issue of whether to adopt a “wait and watch” strategy or to initiate drug therapy soon after diagnosis in Parkinson’s disease (PD) has been the subject of some debate. A recent observational study supported early treatment by demonstrating deterioration in self-reported health status in those left untreated, but not those who received therapy. We aimed to replicate this observation.Methods: People with PD from a prospective incidence study underwent follow-up with yearly clinical assessment of parkinsonian impairment (Unified Parkinson’s Disease Rating Scale (UPDRS)) and self-reported health status (Parkinson’s Disease Questionnaire (PDQ-39)). Two year outcomes were compared with those who started treatment within 1 year of diagnosis and those left untreated.Results: 42 patients with PD were followed-up for 2 years, of whom 26 started treatment during the first year and 16 remained untreated. Those receiving treatment had significantly higher UPDRS and PDQ-39 scores at baseline. There was no significant deterioration in PDQ-39 score in either group (median change untreated 0.8 vs treated 4.0; p = 0.47), despite a significant difference in the change in motor UPDRS scores (untreated 6.0 vs treated −6.0; p = 0.03).Conclusion: Given the lack of significant deterioration in the PDQ-39 in untreated patients, we believe a “wait and watch” strategy for the treatment of newly diagnosed PD remains a credible approach unless randomised trials prove otherwise.