Document Type : Research articles


1 Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China

2 The Second People’s Hospital of Lianyungang, Lianyungang, China

3 Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou, China


Background: Levodopa treatment is the gold standard in Parkinson’s disease but has the risk of dyskinesias. Selegiline delays the introduction of levodopa and pramipexole is used as a symptomatic treatment in Parkinson’s disease.
Objectives: This study aimed to compare the effectiveness of pramipexole with selegiline in Parkinson’s disease patients.
Methods: Data regarding motor and cognitive impairments and plasma phospholipids of 500 Chinese patients with confirmed Parkinson’s disease from medical records of 1 January 2015 to 1 June 2016 were retrospectively evaluated. Patients received either pramipexole (PP cohort, n = 250) or selegiline (SG cohort, n = 250). Also, data regarding hospitalization, adverse effects, and expen- diture were collected and analyzed from records of the follow-up period.
Results: After 3-years of treatments, selegiline and pramipexole both improved motor and cognitive impairments and decreased plasma phospholipid levels (P < 0.05 for all). The intensity of improvement in motor and cognitive impairments and a decrease in the level of plasma phospholipids for pramipexole was higher than those of selegiline (P < 0.05 for all). Pramipexole caused muscle weakness (P = 0.015) and peripheral edema (P = 0.0004). While, selegiline caused cardiovascular disease (P = 0.008). Higher numbers of patients in the SG cohort were hospitalized during 3-years of treatment than those in PP cohort (11 vs. 1, P = 0.009). Selegiline treatment is more expensive than pramipexole (4,457 ± 345 ¥ vs. 3,649 ± 301 ¥/patient/year, P < 0.0001).
Conclusions: Pramipexole treatment may have better improvement in motor and cognitive impairments than selegiline with neu- roprotective action and manageable side effects (Level of Evidence: III).