%0 Journal Article
%T Controversies in Neurology: why monoamine oxidase B inhibitors could be a good choice for the initial treatment of Parkinson's disease
%A Matthias L£¿hle
%A Heinz Reichmann
%J BMC Neurology
%D 2011
%I BioMed Central
%R 10.1186/1471-2377-11-112
%X In multiple studies, MAO-B inhibitors, such as selegiline and rasagiline, have shown to provide mild symptomatic effects, delay the need for levodopa, and to reduce the incidence of motor fluctuations. Although their symptomatic efficacy is inferior compared to dopamine agonists and levodopa, MAO-B inhibitors undoubtedly have fewer side effects and are easy to administer. In contrary to their competitors, MAO-B inhibitors may furthermore offer a chance for disease modification, which so far remains a major unmet need in the management of PD and eventually makes them ideal candidates for the early treatment of the disease.MAO-B inhibitors may constitute a preferable therapeutic option for early PD, mainly due to their favourable safety profile and their putative neuroprotective capabilities. Since the symptomatic effects of MAO-B inhibitors are comparatively mild, dopamine agonists and levodopa should however be considered for initial treatment in those PD patients, in whom robust and immediate symptomatic relief needs to be prioritized.Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and estimated to affect about 1-2% of the population over 65 years [1]. Early treatment of emerging symptoms is nowadays widely recommended, since PD patients left untreated at diagnosis show a significant worsening in their health related quality of life in comparison to those patients in whom treatment is initiated at or soon after diagnosis [2]. Furthermore, it has been proposed that early treatment of PD may be associated with a correction of basal ganglia functional abnormalities caused by dopaminergic cell loss and dopamine deficiency and could therefore support intrinsic physiological compensatory mechanisms during the course of the disease [3].Once PD has been diagnosed, physicians eventually find themselves faced by the question, which substance to choose for the initial treatment of the disease. Fortunately, we are nowadays
%U http://www.biomedcentral.com/1471-2377/11/112