Parkinsonism and Related Disorders xxx (2014) 1e2
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Correspondence
Response to “No evidence of neuroprotection? Perhaps not…perhaps so” Keywords: Parkinson's disease Medication Neuroprotection
Table 1 Summary statistics of levadopa equivalent dose (LED) by group.
We appreciate the comments made by Drs. Lewin and Blum, and have addressed this important issue regarding the potential effect medication changes may have had on the results of our study [1]. We reviewed our medication data, and converted all medications to levodopa equivalent dose (LED) [2]. Table 1 shows the mean and median LED by group. Fig. 1 shows that for both the early start and delayed start groups there is a slow increase in medication dose over time, however, there are no striking separations or trends seen between groups. Note that the differences in mean LED between groups is modest and the standard deviations are large. Thus, in our study, we do not believe that changes in medication masked any potential neuroprotective effect.
Week Groupa N
Mean LED Std Dev Median LED Minimum Maximum
0
316.0 299.3 349.7 346.0 359.1 351.3 346.6 359.3 374.7 352.7 369.7 350.0 353.0 350.0
8 16 24 32 40 48 a
ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG
15 14 16 15 16 15 16 15 15 15 15 15 15 15
236.6 177.0 226.7 220.6 232.0 221.4 221.9 208.2 248.4 185.3 269.1 159.7 244.5 159.7
380.0 300.0 390.0 300.0 400.0 300.0 390.0 300.0 450.0 350.0 400.0 360.0 400.0 360.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
700.0 750.0 700.0 780.0 750.0 780.0 650.0 780.0 750.0 750.0 850.0 600.0 750.0 600.0
ESG ¼ entry start group, DSG ¼ delayed start group.
Fig. 1. Longitudinal changes in mean levodopa equivalence by group.
DOI of original article: http://dx.doi.org/10.1016/j.parkreldis.2014.05.002. http://dx.doi.org/10.1016/j.parkreldis.2014.05.001 1353-8020/© 2014 Elsevier Ltd. All rights reserved.
Please cite this article in press as: Park A, et al., Response to “No evidence of neuroprotection? Perhaps not…perhaps so”, Parkinsonism and Related Disorders (2014), http://dx.doi.org/10.1016/j.parkreldis.2014.05.001
2
Correspondence / Parkinsonism and Related Disorders xxx (2014) 1e2
References
Andrea Malone, Alicia Rendon Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, Columbus, OH 43210, USA
[1] Park A, Zid D, Russell J, Malone A, Rendon A, Wehr A, et al. Effects of a formal exercise program on Parkinson's disease: a pilot study using a delayed start design. Parkinsonism Relat Disord 2014 Jan;20(1):106e11. Epub 2013 Oct 15. [2] Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE. Systematic review of levodopa dose equivalency reporting in Parkinson's Disease. Mov Disord 2010;15:2649e85.
Ariane Park* Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, Columbus, OH 43210, USA David Zid, Jackie Russell Columbus Health Works, Columbus, OH 43212, USA
Allison Wehr, Xiaobai Li Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA *
Corresponding author. Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, 395 W 12th Avenue, Columbus, OH 43210, USA. Tel.: þ1 614 293 4969; fax: þ1 614 293 6111. E-mail address: [email protected] (A. Park). 24 April 2014 Available online xxx
Please cite this article in press as: Park A, et al., Response to “No evidence of neuroprotection? Perhaps not…perhaps so”, Parkinsonism and Related Disorders (2014), http://dx.doi.org/10.1016/j.parkreldis.2014.05.001
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Correspondence
Response to “No evidence of neuroprotection? Perhaps not…perhaps so” Keywords: Parkinson's disease Medication Neuroprotection
Table 1 Summary statistics of levadopa equivalent dose (LED) by group.
We appreciate the comments made by Drs. Lewin and Blum, and have addressed this important issue regarding the potential effect medication changes may have had on the results of our study [1]. We reviewed our medication data, and converted all medications to levodopa equivalent dose (LED) [2]. Table 1 shows the mean and median LED by group. Fig. 1 shows that for both the early start and delayed start groups there is a slow increase in medication dose over time, however, there are no striking separations or trends seen between groups. Note that the differences in mean LED between groups is modest and the standard deviations are large. Thus, in our study, we do not believe that changes in medication masked any potential neuroprotective effect.
Week Groupa N
Mean LED Std Dev Median LED Minimum Maximum
0
316.0 299.3 349.7 346.0 359.1 351.3 346.6 359.3 374.7 352.7 369.7 350.0 353.0 350.0
8 16 24 32 40 48 a
ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG ESG DSG
15 14 16 15 16 15 16 15 15 15 15 15 15 15
236.6 177.0 226.7 220.6 232.0 221.4 221.9 208.2 248.4 185.3 269.1 159.7 244.5 159.7
380.0 300.0 390.0 300.0 400.0 300.0 390.0 300.0 450.0 350.0 400.0 360.0 400.0 360.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
700.0 750.0 700.0 780.0 750.0 780.0 650.0 780.0 750.0 750.0 850.0 600.0 750.0 600.0
ESG ¼ entry start group, DSG ¼ delayed start group.
Fig. 1. Longitudinal changes in mean levodopa equivalence by group.
DOI of original article: http://dx.doi.org/10.1016/j.parkreldis.2014.05.002. http://dx.doi.org/10.1016/j.parkreldis.2014.05.001 1353-8020/© 2014 Elsevier Ltd. All rights reserved.
Please cite this article in press as: Park A, et al., Response to “No evidence of neuroprotection? Perhaps not…perhaps so”, Parkinsonism and Related Disorders (2014), http://dx.doi.org/10.1016/j.parkreldis.2014.05.001
2
Correspondence / Parkinsonism and Related Disorders xxx (2014) 1e2
References
Andrea Malone, Alicia Rendon Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, Columbus, OH 43210, USA
[1] Park A, Zid D, Russell J, Malone A, Rendon A, Wehr A, et al. Effects of a formal exercise program on Parkinson's disease: a pilot study using a delayed start design. Parkinsonism Relat Disord 2014 Jan;20(1):106e11. Epub 2013 Oct 15. [2] Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE. Systematic review of levodopa dose equivalency reporting in Parkinson's Disease. Mov Disord 2010;15:2649e85.
Ariane Park* Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, Columbus, OH 43210, USA David Zid, Jackie Russell Columbus Health Works, Columbus, OH 43212, USA
Allison Wehr, Xiaobai Li Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA *
Corresponding author. Madden Center for Parkinson's Disease and Related Disorders, Wexner Medical Center at The Ohio State University, 395 W 12th Avenue, Columbus, OH 43210, USA. Tel.: þ1 614 293 4969; fax: þ1 614 293 6111. E-mail address: [email protected] (A. Park). 24 April 2014 Available online xxx
Please cite this article in press as: Park A, et al., Response to “No evidence of neuroprotection? Perhaps not…perhaps so”, Parkinsonism and Related Disorders (2014), http://dx.doi.org/10.1016/j.parkreldis.2014.05.001
