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It is edited by Dr. The Journal accepts works on basic as well applied research on any field of neurology.

The Impact Factor measures the average number of "Norelys rodriguez edad" received in a particular year by papers published in the journal during the two receding years. CiteScore measures average citations received per document published.

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Several therapeutic options are available for the symptomatic treatment of Parkinson's disease PD.

There is no reliable information about which factors are involved in the choice of treatment. We completed a descriptive cross-sectional retrospective multicentre study of patients with idiopathic PD receiving LCE. Clinical data were collected with special attention to factors that could potentially determine when to initiate treatment with LCE in normal clinical practice. We studied patients with a mean age of Average Norelys rodriguez edad from the onset of symptoms to diagnosis was The most common initial symptoms were tremor Eight hundred twenty-two patients Clinical factors with a moderate, marked, or crucial effect on the decision to start LCE treatment were bradykinesia Difficulty performing activities of daily living was the only psychosocial factor identified as having an influence on the decision The decision to start patients with idiopathic PD on LCE treatment is mainly determined by motor deficits and Norelys rodriguez edad associated with disease progression.

Parkinson's disease PD presents with both motor symptoms resting tremor, bradykinesia and rigidity and nonmotor symptoms. In Spain, PD prevalence Norelys rodriguez edad estimated at 1. Since not enough information is available on the factors influencing some therapeutic decisions made during the course of PD, 14 performing studies to identify such influences seems to be justified. This retrospective study aims to identify the factors affecting the decision by Spanish neurologists to prescribe this treatment in normal clinical practice.

To our knowledge, no other study with a similar aim Norelys rodriguez edad been carried out in our setting, and the results of our study may be useful for increasing knowledge in this field. We carried out an observational, cross-sectional, retrospective multicentre study in Spain under normal clinical practice conditions. Each participating neurologist recorded data from at least 10 patients treated with LCE until a total of eligible patients had been included.

We included patients aged 18 years and older with idiopathic PD treated with LCE during a minimum of 3 months before inclusion in the study. Patients were excluded if they were participating Norelys rodriguez edad a clinical trial during treatment with LCE and if their state of health, in the researcher's opinion, would not permit them to be included in the study.

We collected clinical Norelys rodriguez edad from the patients by reviewing their medical histories, paying special attention to the factors determining "Norelys rodriguez edad" LCE treatment was started in normal clinical practice. In addition to the clinical symptoms specific to PD, we recorded time since diagnosis, initial symptoms, Hoehn and Yahr scale score, "Norelys rodriguez edad" parts Norelys rodriguez edad activities of daily living and 3 motor examination of the Unified Parkinson Disease Rating Scale UPDRS16 Schwab and England Activities of Daily Living Scale, 17 any previous treatments, and the start date for the different treatments.

Furthermore, we analysed associations between the demographic and clinical variables recorded and pathological factors linked to disease progression and to onset of LCE treatment. Typical descriptive statistics were used according to the characteristics of the variables categorical or continuous.

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The Chi-square test was used with qualitative variables. After identifying the clinical and psychosocial determinants, we established the association between these factors and the Norelys rodriguez edad characteristics of the patients. To do so, we applied a logistic regression model for each determinant as the dependent variable using backward stepwise selection of the non-significant sociodemographic variables independent variables.

Statistical analyses were performed using SAS statistical software, version 9. The baseline condition of the patients at the start of LCE treatment was as follows. Hoehn and Yahr scale "Norelys rodriguez edad" for Mean score on the Schwab and England scale available Norelys rodriguez edad Table 1 displays other sociodemographic and medical history data for the sample.

Sociodemographic characteristics of patients at the start of LCE treatment.

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The time elapsed between the onset of typical PD symptoms and the time of the study was 6. Table 2 displays other time data having to do with medical and treatment history. Relevant periods in patient's medical and treatment history.

Initial characteristic symptoms included tremor First-line therapy for Parkinson's disease in the sample. More than one treatment may be "Norelys rodriguez edad" for the same patient. Table 4 summarises all the clinical Norelys rodriguez edad psychosocial factors assessed at the start of LCE treatment.

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The assessed clinical factors included typical signs of PD tremor, rigidity, and bradykinesiadifficulty walking, loss of manual dexterity, Norelys rodriguez edad fluctuations, and general clinical decline. Some of the most important clinical factors affecting the decision to start LCE treatment were bradykinesia Other clinical factors were decisive for some patients wearing-off: Factors influencing the decision to start LCE treatment.

Percentage calculated based on the total patients presenting the symptom. Clinical determinants in the decision to start LCE treatment. Among the psychosocial factors considered, clumsiness and difficulty performing activities of daily living were Norelys rodriguez edad in the decision to start LCE treatment in The summary of the association between the identified determinants and the sociodemographic characteristics is as follows.

The main aim of the study included Norelys rodriguez edad clinical and psychosocial factors with a potentially Norelys rodriguez edad effect on the neurologist's decision to begin LCE treatment for PD. Most of the PD patients who started LCE treatment presented motor symptoms at the approximate age of 65 years. They were mainly men with a primary or Norelys rodriguez edad education, retired, and living with a domestic partner.

This demographic profile coincides with profiles described by other series on specialised care. Levodopa excluding Norelys rodriguez edad and dopaminergic agonists were the drugs most frequently used as first-line treatment. Although levodopa is effective for improving motor performance, 20 doctors prescribing this drug should be aware that it is associated with motor complications in more than half of the patients after the first 5 years of treatment.

Consequently, these formulations have become useful alternatives for treating motor manifestations and subsequent disability, and generally speaking, they show better tolerability than dopaminergic agonists. This study demonstrated that starting levodopa treatment with LCE did not delay or decrease the frequency of dyskinesias and may even increase them.

Among those patients for whom we have data on Norelys rodriguez edad start of LCE treatment, Most of these patients were not fully independent for activities of daily living or else performed tasks slowly and Norelys rodriguez edad difficulty.

Analysis of clinical factors involved in the start of LCE treatment found that the main determinants were bradykinesia, general clinical decline, and daytime rigidity, followed by difficulty "Norelys rodriguez edad," tremor, nocturnal rigidity, and postural instability.

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Wearing-off and other motor fluctuations were determining factors for the patients presenting them. The Norelys rodriguez edad determinant among the psychosocial factors was difficulty performing activities of daily living.

These factors coincide with the areas that improve the most with LCE "Norelys rodriguez edad" in patients experiencing the wearing-off effect, according to a recent post hoc analysis. However, the decision of when to start this treatment depends on the highly idiosyncratic relationship between the patient and the disease. Once doctors decide to start treatment for PD, they must choose among different strategies MAO inhibitors, dopaminergic agonists, and levodopa in combination with a decarboxylase inhibitor.

The most suitable treatment must be chosen based on the patient's characteristics age, level of disability, occupation, etc. This circumstance must Norelys rodriguez edad considered alongside the patient's age and functional requirements.

The different regression models developed indicated that age, residential setting, and employment status were associated with different clinical determinants. This creates a complex framework of individual, clinical, and social interrelationships in which overall mobility and functional capacity differ between subgroups and are relevant when making Norelys rodriguez edad decisions.

Of the study's limitations, the following are especially important: The main contribution of this study, despite the limitations mentioned above, is that it demonstrates that LCE treatment onset is linked to functional decline and more noticeable signs of neurological impairment in the patient. Future studies focusing on quality of life may be able to evaluate the benefits of LCE treatment 27,31 and the possible decrease of that benefit if the start Norelys rodriguez edad the appropriate therapy is delayed.

Vicente Bertol Alegre H. Eugenia Villar Villar C. Llerena, BadajozM. Please cite this article as: Previous article Next article. April Pages This item has received. Show more Show less. Introduction Several therapeutic options are available for the symptomatic treatment of Parkinson's disease PD.

There is no Norelys rodriguez edad information about which factors are involved in the choice of treatment. Patients and methods We completed a descriptive cross-sectional retrospective multicentre study of patients with idiopathic PD receiving LCE.

Clinical data were collected with special attention to factors that could potentially determine when to initiate treatment with LCE in normal clinical practice. Results We studied patients with a mean age of Conclusions The decision to start patients with idiopathic PD on LCE treatment is Norelys rodriguez edad determined by motor deficits and disabilities associated with disease progression.

Introduction Parkinson's disease PD presents with both motor symptoms resting tremor, bradykinesia and rigidity and nonmotor symptoms. To our knowledge, no other study with a similar aim has been carried out in our setting, and the results of our study may be useful for increasing knowledge Norelys rodriguez edad this field.

Patients and methods We carried out an observational, cross-sectional, retrospective multicentre study in Spain under normal clinical practice conditions. Patients were excluded if they were participating in a clinical trial during treatment with LCE and if their state of health, in the researcher's opinion, would not permit them to be included in the study. The Chi-square test was used with qualitative variables. Table 1 displays other sociodemographic and medical history data for the sample.

Sociodemographic characteristics of patients at the start of LCE treatment. Alfredo Nunez is on Facebook. Join Facebook to connect with Alfredo Nunez and Norelys rodriguez edad you may know.

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It is edited by Dr. The Journal accepts works on basic as entirely applied research on any field of neurology. The Impact Factor measures the average number of citations received in a certain year by papers published in the journal until the two receding years.

CiteScore measures average citations received per document published. SRJ is a glamour metric based on the idea that not all citations are the unchanged. SJR uses a comparable algorithm as the Dmoz page rank; it provides a quantitative and qualitative measure of the journal's impact.

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The initial treatment of Parkinson's disease should begin with levodopa. Mean score on the Schwab and England scale available for Several therapeutic options are available for the symptomatic treatment of Parkinson's disease PD. Arch Neurol, 52 , pp. Acta Neurol Scand, , pp. This demographic profile coincides with profiles described by other series on specialised care. Neurology, 58 , pp.

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