Diagnosis and Treatment of Parkinson's Disease: A Systematic Review of the Literature. Evidence Report/Technology Assessment Number 57

摘要

This evidence report shows the results of a literature search by MetaWork, Inc. (an Evidence-Based Practice Center sponsored by the Agency for Healthcare Research and Quality) on the quantity and quality of published evidence regarding the diagnosis and treatment of patients with Parkinson's Disease (PD). PD is estimated to affect over 1 percent of the population over age 65. It is diagnosed clinically; there is currently no gold standard premorbid diagnostic test for PD. Meta-analyses of different pharmacological treatments showed that the only medication that consistently controlled PD symptoms better than levodopa (L-dopa) alone was the combination of L-dopa plus catechol O-methyl transferase (COMT) inhibitors in patients with advanced PD. Meta-analyses suggest that pallidotomy and deep brain stimulation (DBS) result in improvement of PD rating scores. The published literature regarding PD suffers from a lack of reporting of standardized outcomes.