Evidence map›Paper›PMID 40415148›Full record

ArticleCNS drugs2025

Motor and Non-motor Complications Following Different Early Therapies in Parkinson's Disease: Longitudinal Analysis of Real-Life Clinical and Therapeutic Data from the French NS-PARK Cohort.

Aymeric Lanore, Edouard Januel, Nathalie Bertille, Margherita Fabbri, Louise-Laure Mariani, Graziella Mangone, Sara Sambin, Poornima Jayadev Menon, Melissa Tir, Matthieu Bereau and 25 more

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04888364 (Cohort of the French Clinical Research Network for Parkinson's Disease), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04888364 recruitingnot on this map

Cohort of the French Clinical Research Network for Parkinson's Disease (NS-PARK Cohort)

Typeobservational_patient_registrySponsorInstitut National de la Santé Et de la Recherche Médicale, FranceRan2021 to 2034Enrolled30,000ConditionsParkinson Disease
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Aymeric LanoreDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France. aymeric.lanore@icm-institute.org.ORCID 0000-0002-8251-3410
Edouard JanuelDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
Nathalie BertilleDépartement de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, CIC-1901, 75013, Paris, France.
Margherita FabbriClinical Investigation Center CIC1436, Parkinson Expert Center, Department of Clinical, Pharmacology and Neuroscience, NS-Park/FCRIN Network, NeuroToul COEN Center, Toulouse, University Hospital, INSERM and University of Toulouse 3, Toulouse, France.
Louise-Laure MarianiDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
Graziella MangoneDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
Sara SambinDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
Poornima Jayadev MenonDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
Melissa TirDepartment of Neurology, NS-Park/FCRIN network, Amiens University Hospital, Amiens, France.
Matthieu BereauDepartment of Neurology, Hôpital Jean Minjoz, Besançon, France.
Wassilios G MeissnerCHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc, NS-Park/FCRIN Network, 33000, Bordeaux, France.
Claire ThiriezDepartment of Neurology, NS-Park/FCRIN Network, CHU Caen, Caen, France.
Ana MarquesDepartment of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Philippe RemyCentre Expert Parkinson and NS-Park/FCRIN Network, CHU Henri Mondor, AP-HP et Equipe Neuropsychologie Interventionnelle, INSERM-IMRB, Faculté de Santé, Université Paris-Est Créteil et Ecole Normale Supérieure PSL Université, Créteil, France.
Gwendoline DupontDepartment of Neurology, François Mitterrand University Hospital, University de Bourgogne, Dijon, France.
Elena MoroDivision of Neurology, Movement Disorders Unit, CHU de Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, Grenoble, France.
Luc DefebvreService de Neurologie et Pathologie du Mouvement, Pôle de Neurosciences et Appareil Locomoteur, CHRU de Lille, Lille, France.
Jean Luc HouetoDepartment of Neurology, NS-Park/FCRIN Network, Limoges University Hospital, Inserm, U1094, EpiMaCT-Epidemiology of Chronic Diseases in Tropical Zone, Limoges University Hospital, 87042, Limoges, France.
Stéphane ThoboisHospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer, Department of Neurology C, NS-Park/FCRIN Network, Univ Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Lyon, France.
Jean-Philippe AzulayDepartment of Neurology and Movement Disorders, NS-Park/FCRIN Network; APHM, Hôpital Universitaire Timone, 13005, Marseille, France.
Christian GenyCentre Expert Maladie de Parkinson, Service de Neurologie, Hôpital Gui de Chauliac, Montpellier, France.
Solène FrismandDepartment of Neurology, NS-Park/FCRIN Network, University Hospital of Nancy, Nancy, France.
Philippe DamierCHU de Nantes, CIC1413, Nantes & Université de Nantes, UFR Médecine, Nantes, France.
Caroline GiordanaNeurology Department, NS-Park/FCRIN Network, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
Giovanni CastelnovoDepartment of Neurology, NS-Park/FCRIN Network; CHU de Nîmes, Nîmes, France.
Solène AnsquerDepartment of Neurology, University Hospital of Poitiers; INSERM-CIC1402, Poitiers, France.
Anne Doe De MaindrevilleDepartment of Neurology, NS-park/FCRIN Network, CHU Reims, Reims, France.
Sophie DrapierDepartment of Neurology, CIC INSERM 1414, Pontchaillou University Hospital, Rennes, France.
David MaltêteDepartment of Neurology, Rouen University Hospital and University of Rouen, France, INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, NS-Park/FCRIN Network, Mont-Saint-Aignan, France.
Christine TranchantService de Neurologie, NS-Park/FCRIN Network; Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.
Olivier RascolClinical Investigation Center CIC1436, Parkinson Expert Center, Department of Clinical, Pharmacology and Neuroscience, NS-Park/FCRIN Network, NeuroToul COEN Center, Toulouse, University Hospital, INSERM and University of Toulouse 3, Toulouse, France.
Florence TubachDépartement de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, CIC-1901, 75013, Paris, France.
Yann De RyckeDépartement de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, CIC-1901, 75013, Paris, France.
Jean-Christophe CorvolDepartment of Neurology, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, NS-Park/FCRIN Network, Paris, France.
French NS-Park Network

Funding

Investissements d'avenir ANR-10- IAIHU-06
6 · The paper itself

Abstract

backgroundLevodopa, dopamine agonists (DA) and monoamine oxidase inhibitors (MAOI) are all approved first-line therapies for Parkinson's disease (PD), as monotherapy or in combination. Data on their use in the early management of patients with PD in real-life are lacking. Our objective was to assess the impact of early therapeutic strategies on the development of motor and neuropsychiatric complications using a nationwide PD cohort.

methodsNS-PARK is a cohort of patients with PD recruited between 2011 and 2021 from 26 expert centres for PD in France. We analysed the patients with less than 5-years disease duration and no motor complications at inclusion. We used interval censoring survival models to assess the associations between therapeutic strategies (levodopa monotherapy, levodopa alternative therapies or levodopa combinations) and motor fluctuations, dyskinesia, impulse control and related behaviours (ICRBs), apathy, psychosis/hallucination and daytime sleepiness. Analyses were adjusted for sex, age, disease duration, dopaminergic dose and disease severity.

resultsWe included 1722 patients (38.4% female, median age 67.7 years). At inclusion, 41% received levodopa monotherapy, 31% received levodopa alternative therapies and 28% received levodopa combinations. Compared with levodopa monotherapy, levodopa alternative therapies were associated with a lower dyskinesia risk (hazard ratio (HR) 0.48, 95% confidence interval (CI)[0.28-0.84]), but there was no significant difference in motor fluctuations. Both levodopa alternative and combinations therapies increased ICRBs risk (HR 4.06, 95% CI [2.48-6.67]; HR 5.16, 95% CI [3.00-8.86]) and decreased apathy risk (HR 0.36, 95% CI [0.26-0.49]; HR 0.52, 95% CI [0.39-0.69]). No association was found with psychosis/hallucination or daytime sleepiness.

conclusionsIn this real-life cohort, our data supported an association between levodopa alternative therapies and a lower risk of dyskinesia and apathy, but a higher risk of ICRBs compared with levodopa monotherapy. CLINICALTRIALS: GOV IDENTIFIER: NCT04888364. Registered June 2021.

Indexed as

Antiparkinson AgentsLevodopaParkinson DiseaseAgedCohort StudiesDopamine AgonistsDrug Therapy, CombinationDyskinesia, Drug-InducedFemaleFranceHumansLongitudinal StudiesMaleMiddle AgedMonoamine Oxidase InhibitorsAntiparkinson AgentsDopamine AgonistsLevodopaMonoamine Oxidase Inhibitors

Identifiers

PMID40415148

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