Publications by authors named "Sven R Suwijn"
Background And Objective: The Levodopa in EArly Parkinson's disease study showed no effect of earlier versus later levodopa initiation on Parkinson's disease (PD) progression over 80 weeks. We now report the effects over 5 years.
Methods: The Levodopa in EArly Parkinson's disease study randomly assigned patients to levodopa/carbidopa 300/75 mg daily for 80 weeks (early start) or to placebo for 40 weeks followed by levodopa/carbidopa 300/75 mg daily for 40 weeks (delayed start).
Changes in neurologists' treatment preferences for Parkinson's disease in the Netherlands.
Clin Park Relat Disord
February 2024
•Data about treatment preferences for Parkinson's disease (PD) are scarce.•A survey was sent to neurologists in the Netherlands in 2010 and 2021.•In 2021, levodopa was increasingly prescribed for PD.
View Article and Find Full Text PDFBackground And Objectives: The Levodopa in EArly Parkinson's Disease (LEAP) study enabled us to conduct post hoc analyses concerning the effects of levodopa in patients with early Parkinson disease.
Methods: The LEAP study was a double-blind, placebo-controlled, randomized, delayed-start trial in which patients with early Parkinson disease were randomized to receive levodopa/carbidopa 300/75 mg daily for 80 weeks (early-start group) or to placebo for 40 weeks followed by levodopa/carbidopa 300/75 mg daily for 40 weeks (delayed-start group). We analyzed the effect of levodopa with the Unified Parkinson's Disease Rating Scale on bradykinesia, rigidity, and tremor.
Background: In the Levodopa in EArly Parkinson's disease (LEAP) study, 445 patients were randomized to levodopa/carbidopa 100/25 mg three times per day for 80 weeks (early-start) or placebo for 40 weeks followed by levodopa/carbidopa 100/25 mg three times per day for 40 weeks (delayed-start).
Objective: This paper reports the results of the economic evaluation performed alongside the LEAP-study.
Methods: Early-start treatment was evaluated versus delayed-start treatment, in which the cost-effectiveness analysis (CEA) and the cost-utility analysis (CUA) were performed from the societal perspective, including health care costs among providers, non-reimbursable out-of-pocket expenses of patients, employer costs of sick leave, and lowered productivity while at work.
Background: In clinical trials that recruited patients with early Parkinson's disease (PD), 4-15% of the participants with a clinical diagnosis of PD had normal dopamine transporter single photon emission computed tomography (DAT SPECT) scans, also called "scans without evidence of dopaminergic deficit" (SWEDD).
Objective: To investigate in patients with a clinical diagnosis of PD, if specific clinical features are useful to distinguish patients with nigrostriatal degeneration from those that have no nigrostriatal degeneration.
Methods: We performed a diagnostic test accuracy study.
Article Synopsis
- * Results showed that there was a high agreement (98.7%) between initial local assessments and expert reassessments of the scans, indicating reliability in visual evaluation by non-experts.
- * Despite the reliability, many neurologists (73.6%) request DAT SPECT imaging primarily to distinguish between neurodegenerative and non-neurodegenerative parkinsonism, not realizing that its accuracy is not as effective for differentiating various types of parkinsonian syndromes.
Background: Levodopa is the main treatment for symptoms of Parkinson's disease. Determining whether levodopa also has a disease-modifying effect could provide guidance as to when in the course of the disease the treatment with this drug should be initiated.
Methods: In a multicenter, double-blind, placebo-controlled, delayed-start trial, we randomly assigned patients with early Parkinson's disease to receive levodopa (100 mg three times per day) in combination with carbidopa (25 mg three times per day) for 80 weeks (early-start group) or placebo for 40 weeks followed by levodopa in combination with carbidopa for 40 weeks (delayed-start group).
Article Synopsis
- Parkinson's disease (PD) is often misdiagnosed in 6 to 25% of cases at specialized movement disorder centers, highlighting the need for better diagnostic methods.
- Dopamine transporter single-photon emission computed tomography (DAT SPECT) imaging shows promise as a reliable reference standard due to its high diagnostic accuracy in detecting nigrostriatal cell loss in early parkinsonism.
- A review of eight selected studies found that DAT SPECT imaging had a sensitivity of 98% to 100% in diagnosing nigrostriatal cell loss, suggesting its effectiveness for patients with parkinsonism, including those with diagnostic uncertainty.
The role of SPECT imaging of the dopaminergic system in translational research on Parkinson's disease.
Parkinsonism Relat Disord
January 2014
Imaging of the dopaminergic system with single photon emission computed tomography (SPECT), and particularly of the dopamine transporter (DAT) located in the striatum, is a well accepted tool in clinical practice to confirm or exclude loss of nigrostriatal dopamine (DA) neurons in patients suspected to suffer from Parkinson's disease (PD). SPECT techniques were developed successfully to image neurotransmitter systems, including the presynaptic DAT and postsynaptic dopamine D2/3 receptors, in rat and mouse models of PD. Here we review the results of preclinical SPECT studies of the dopaminergic system in rat and mouse models of PD.
View Article and Find Full Text PDFBackground: Although the treatment of Parkinson's disease (PD) is very effective, in the course of the disease, 40% to 60% of patients develop dyskinesias. The pathophysiology of dyskinesias is still unclear. Results of preclinical research suggest that uptake and uncontrolled release of dopamine by serotonergic neurons is an important factor.
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