A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit.

Importance: Coenzyme Q10 (CoQ10), an antioxidant that supports mitochondrial function, has been shown in preclinical Parkinson disease (PD) models to reduce the loss of dopamine neurons, and was safe and well tolerated in early-phase human studies. A previous phase II study suggested possible clinical benefit.

Objective: To examine whether CoQ10 could slow disease progression in early PD.

Medication tolerance and augmentation in restless legs syndrome: the need for drug class rotation.

Restless legs syndrome (RLS) is a common condition characterized by an unpleasant urge to move the legs that usually occurs at night and may interfere with sleep. The medications used most commonly to treat RLS include dopaminergic drugs (levodopa, dopamine agonists), benzodiazepines, and narcotic analgesics. We report the cases of 2 patients with RLS who illustrate the problems of tolerance (declining response over time) and augmentation (a worsening of symptoms due to ongoing treatment) that can complicate the pharmacotherapy of RLS.

Assistive devices for gait in Parkinson's disease.

While medications have improved the function of patients with Parkinson's disease (PD), over time most patients experience progressive problems with gait and balance. There have been important recent advances in the development of mechanical assistive devices that have the potential of improving mobility, but there are possible risks and the optimal role for such devices in PD has not been carefully studied. We review the available literature and provide practical information about available mobility assistive devices for patients with PD.