Over the past 50 years, symptomatic therapy for Parkinson's disease has involved the use of levodopa, with the subsequent licensing of dopamine agonists and monoamine oxidase-B (MAO-B) inhibitors. Dopaminergic therapy substantially improves motor symptoms, reducing bradykinesia, rigidity, and tremor, and enhancing both quality of life and life expectancy. For some years there has been a debate among clinicians regarding the timing of the introduction and the sequencing of these drugs. In a comprehensive Review, Rob de Bie and colleagues seek to clarify these issues; their recommendations are worthy of support, but also of some nuancing. The authors suggest that the default position should be to start patients with Parkinson's disease on levodopa; however, I think that alternative approaches can be considered.

中文翻译：

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实用的个性化治疗帕金森氏病的方法。

在过去的50年中，帕金森氏病的对症治疗涉及左旋多巴的使用，随后多巴胺激动剂和单胺氧化酶B（MAO-B）抑制剂获得许可。多巴胺能疗法可大大改善运动症状，减少运动迟缓，僵硬和震颤，并提高生活质量和预期寿命。多年来，临床医生之间一直在争论这些药物的引入时间和顺序。在全面的审查中，Rob de Bie及其同事试图澄清这些问题。他们的建议值得支持，但也应有所帮助。作者建议，默认位置应该是在左旋多巴上开始帕金森病患者。但是，我认为可以考虑使用其他方法。