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Volumn 66, Issue 7, 2006, Pages 976-982

Practice parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology

Author keywords

[No Author keywords available]

Indexed keywords

AMANTADINE; CHOLINERGIC RECEPTOR BLOCKING AGENT; DOPAMINE RECEPTOR STIMULATING AGENT; FOOD ADDITIVE; LEVODOPA; PRAMIPEXOLE; RASAGILINE; RILUZOLE; ROPINIROLE; UBIDECARENONE;

EID: 33646104205     PISSN: 00283878     EISSN: None     Source Type: Journal    
DOI: 10.1212/01.wnl.0000206363.57955.1b     Document Type: Article
Times cited : (210)

References (60)
  • 1
    • 0037039267 scopus 로고    scopus 로고
    • Practice parameter: Initiation of treatment for Parkinson's disease: An evidence-based review: Report of the Quality Standards Subcommittee of the American Academy of Neurology
    • Miyasaki JM, Martin W, Suchowersky O, Weiner WJ, Lang AE. Practice parameter: initiation of treatment for Parkinson's disease: an evidence-based review: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2002;58:11-17.
    • (2002) Neurology , vol.58 , pp. 11-17
    • Miyasaki, J.M.1    Martin, W.2    Suchowersky, O.3    Weiner, W.J.4    Lang, A.E.5
  • 2
    • 0035845719 scopus 로고    scopus 로고
    • The use of alternative therapies by patients with Parkinson's disease
    • Rajendran PR, Thompson RE, Reich SG. The use of alternative therapies by patients with Parkinson's disease. Neurology 2001;57:790-794.
    • (2001) Neurology , vol.57 , pp. 790-794
    • Rajendran, P.R.1    Thompson, R.E.2    Reich, S.G.3
  • 4
    • 0033021724 scopus 로고    scopus 로고
    • Nonpharmacologic management strategies
    • Wright JC. Nonpharmacologic management strategies. Med Clin North Am 1999;83:499-508, viii.
    • (1999) Med Clin North Am , vol.83 , pp. 499-508
    • Wright, J.C.1
  • 5
    • 0141722276 scopus 로고    scopus 로고
    • Surrogate endpoints in Parkinson's disease research
    • Biglan KM, Holloway RG. Surrogate endpoints in Parkinson's disease research. Curr Neurol Neurosci Rep 2003;3:314-320.
    • (2003) Curr Neurol Neurosci Rep , vol.3 , pp. 314-320
    • Biglan, K.M.1    Holloway, R.G.2
  • 6
    • 19944432710 scopus 로고    scopus 로고
    • The role of radiotracer imaging in Parkinson disease
    • Ravina B, Eidelberg D, Ahlskog JE, et al. The role of radiotracer imaging in Parkinson disease. Neurology 2005;64:208-215.
    • (2005) Neurology , vol.64 , pp. 208-215
    • Ravina, B.1    Eidelberg, D.2    Ahlskog, J.E.3
  • 7
    • 0037202792 scopus 로고    scopus 로고
    • Dopamine agonist monotherapy in Parkinson's disease
    • Clarke C, Guttman M. Dopamine agonist monotherapy in Parkinson's disease. Lancet 2002;360:1767-1769.
    • (2002) Lancet , vol.360 , pp. 1767-1769
    • Clarke, C.1    Guttman, M.2
  • 8
    • 0026636491 scopus 로고
    • A pilot trial of high-dose alpha-tocopherol and ascorbate in early Parkinson's disease
    • Fahn S. A pilot trial of high-dose alpha-tocopherol and ascorbate in early Parkinson's disease. Ann Neurol 1992;32 Suppl:S128-132.
    • (1992) Ann Neurol , vol.32 , Issue.SUPPL.
    • Fahn, S.1
  • 9
    • 0027530638 scopus 로고
    • Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease
    • The Parkinson Study Group
    • The Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. The Parkinson Study Group. N Engl J Med 1993;328:176-183.
    • (1993) N Engl J Med , vol.328 , pp. 176-183
  • 10
    • 0036164536 scopus 로고    scopus 로고
    • A double-blind, placebo-controlled and longitudinal study of riluzole in early Parkinson's disease
    • Jankovic J, Hunter C. A double-blind, placebo-controlled and longitudinal study of riluzole in early Parkinson's disease. Parkinsonism Relat Disord 2002;8:271-276.
    • (2002) Parkinsonism Relat Disord , vol.8 , pp. 271-276
    • Jankovic, J.1    Hunter, C.2
  • 11
    • 0036771852 scopus 로고    scopus 로고
    • Effects of coenzyme Q10 in early Parkinson disease: Evidence of slowing of the functional decline
    • Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol 2002;59:1541-1550.
    • (2002) Arch Neurol , vol.59 , pp. 1541-1550
    • Shults, C.W.1    Oakes, D.2    Kieburtz, K.3
  • 12
    • 19744378296 scopus 로고    scopus 로고
    • Levodopa and the progression of Parkinson's disease
    • Parkinson Study Group. Levodopa and the progression of Parkinson's disease. N Engl J Med 2004;351:2498-2508.
    • (2004) N Engl J Med , vol.351 , pp. 2498-2508
  • 13
    • 0034684139 scopus 로고    scopus 로고
    • Pramipexole vs levodopa as initial treatment for Parkinson disease: A randomized controlled trial
    • Parkinson Study Group
    • Parkinson Study Group. Pramipexole vs levodopa as initial treatment for Parkinson disease: a randomized controlled trial. Parkinson Study Group. JAMA 2000;284:1931-1938.
    • (2000) JAMA , vol.284 , pp. 1931-1938
  • 14
    • 0037012478 scopus 로고    scopus 로고
    • Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression
    • Parkinson Study Group. Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA 2002;287:1653-1661.
    • (2002) JAMA , vol.287 , pp. 1653-1661
  • 15
    • 0036921217 scopus 로고    scopus 로고
    • A comparison of the progression of early Parkinson's disease in patients started on ropinirole or L-dopa: An 18F-dopa PET study
    • Rakshi JS, Pavese N, Uema T, et al. A comparison of the progression of early Parkinson's disease in patients started on ropinirole or L-dopa: an 18F-dopa PET study. J Neural Transm 2002;109:1433-1443.
    • (2002) J Neural Transm , vol.109 , pp. 1433-1443
    • Rakshi, J.S.1    Pavese, N.2    Uema, T.3
  • 16
    • 0037785449 scopus 로고    scopus 로고
    • Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL-PET study
    • Whone AL, Watts RL, Stoessl AJ, et al. Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL-PET study. Ann Neurol 2003;54:93-101.
    • (2003) Ann Neurol , vol.54 , pp. 93-101
    • Whone, A.L.1    Watts, R.L.2    Stoessl, A.J.3
  • 17
    • 2342655732 scopus 로고    scopus 로고
    • A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease
    • Parkinson Study Group. A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease. Arch Neurol 2004;61:561-566.
    • (2004) Arch Neurol , vol.61 , pp. 561-566
  • 18
  • 19
    • 0029884473 scopus 로고    scopus 로고
    • Amantadine treatment is an independent predictor of improved survival in Parkinson's disease
    • Uitti RJ, Rajput AH, Ahlskog JE, et al. Amantadine treatment is an independent predictor of improved survival in Parkinson's disease. Neurology 1996;46:1551-1556.
    • (1996) Neurology , vol.46 , pp. 1551-1556
    • Uitti, R.J.1    Rajput, A.H.2    Ahlskog, J.E.3
  • 20
    • 0036809666 scopus 로고    scopus 로고
    • Use of complementary therapies and non-prescribed medication in patients with Parkinson's disease
    • Ferry P, Johnson M, Wallis P. Use of complementary therapies and non-prescribed medication in patients with Parkinson's disease. Postgrad Med J 2002;78:612-614.
    • (2002) Postgrad Med J , vol.78 , pp. 612-614
    • Ferry, P.1    Johnson, M.2    Wallis, P.3
  • 21
    • 10044247488 scopus 로고    scopus 로고
    • Mucuna pruriens in Parkinson's disease: A double blind clinical and pharmacological study
    • Katzenschlager R, Evans A, Manson A, et al. Mucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry 2004;75:1672-1677.
    • (2004) J Neurol Neurosurg Psychiatry , vol.75 , pp. 1672-1677
    • Katzenschlager, R.1    Evans, A.2    Manson, A.3
  • 23
    • 0018227839 scopus 로고
    • Treatment of Parkinson's disease with the cowhage plant-Mucuna pruriens Bak
    • Vaidya AB, Rajagopalan TG, Mankodi NA, et al. Treatment of Parkinson's disease with the cowhage plant-Mucuna pruriens Bak. Neurol India 1978;26:171-176.
    • (1978) Neurol India , vol.26 , pp. 171-176
    • Vaidya, A.B.1    Rajagopalan, T.G.2    Mankodi, N.A.3
  • 24
    • 0029361802 scopus 로고
    • An alternative medicine treatment for Parkinson's disease: Results of a multicenter trial
    • HP-200 Parkinson's Disease Study Group. An alternative medicine treatment for Parkinson's disease: results of a multicenter trial. J Altern Complement Med 1995;1:249-255.
    • (1995) J Altern Complement Med , vol.1 , pp. 249-255
  • 25
    • 0033970684 scopus 로고    scopus 로고
    • Broad bean (Vicia faba) - A natural source of L-dopa-prolongs "on" periods in patients with Parkinson's disease who have "on-off" fluctuations
    • Apaydin H, Ertan S, Ozekmekci S. Broad bean (Vicia faba) - a natural source of L-dopa-prolongs "on" periods in patients with Parkinson's disease who have "on-off" fluctuations. Mov Disord 2000;15:164-166.
    • (2000) Mov Disord , vol.15 , pp. 164-166
    • Apaydin, H.1    Ertan, S.2    Ozekmekci, S.3
  • 27
    • 0026787966 scopus 로고
    • Improvement of parkinsonian features correlate with high plasma levodopa values after broad bean (Vicia faba) consumption
    • Rabey JM, Vered Y, Shabtai H, Graff E, Korczyn AD. Improvement of parkinsonian features correlate with high plasma levodopa values after broad bean (Vicia faba) consumption. J Neurol Neurosurg Psychiatry 1992;55:725-727.
    • (1992) J Neurol Neurosurg Psychiatry , vol.55 , pp. 725-727
    • Rabey, J.M.1    Vered, Y.2    Shabtai, H.3    Graff, E.4    Korczyn, A.D.5
  • 28
    • 0020670169 scopus 로고
    • On-off effects in Parkinson's disease: A controlled investigation of ascorbic acid therapy
    • Reilly DK, Hershey L, Rivera-Calimlim L, Shoulson I. On-off effects in Parkinson's disease: a controlled investigation of ascorbic acid therapy. Adv Neurol 1983;37:51-60.
    • (1983) Adv Neurol , vol.37 , pp. 51-60
    • Reilly, D.K.1    Hershey, L.2    Rivera-Calimlim, L.3    Shoulson, I.4
  • 29
    • 0015519209 scopus 로고
    • A clinical trial of folic acid in Parkinson's disease
    • passim
    • McGeer PL, Zeldowicz L, McGeer EG. A clinical trial of folic acid in Parkinson's disease. Can Med Assoc J 1972;106:145-146 passim.
    • (1972) Can Med Assoc J , vol.106 , pp. 145-146
    • McGeer, P.L.1    Zeldowicz, L.2    McGeer, E.G.3
  • 32
    • 0034574379 scopus 로고    scopus 로고
    • Acupuncture treatment of Parkinson's disease: A report of 29 cases
    • Zhuang X, Wang L. Acupuncture treatment of Parkinson's disease: a report of 29 cases. J Trad Chinese Med 2000;20:265-267.
    • (2000) J Trad Chinese Med , vol.20 , pp. 265-267
    • Zhuang, X.1    Wang, L.2
  • 33
    • 0032794588 scopus 로고    scopus 로고
    • Primary Parkinson's disease: The use of tuina and acupuncture in accord with an evolving hypothesis of its cause from the perspective of Chinese traditional medicine: Part 2
    • Walton-Hadlock J. Primary Parkinson's disease: The use of tuina and acupuncture in accord with an evolving hypothesis of its cause from the perspective of Chinese traditional medicine: part 2. Am J Acupuncture 1999;27:31-49.
    • (1999) Am J Acupuncture , vol.27 , pp. 31-49
    • Walton-Hadlock, J.1
  • 34
    • 0032009224 scopus 로고    scopus 로고
    • Clinical observations on forty cases of paralysis agitans treated by acupuncture
    • Chen L. Clinical observations on forty cases of paralysis agitans treated by acupuncture. J Trad Chinese Med 1998;18:23-26.
    • (1998) J Trad Chinese Med , vol.18 , pp. 23-26
    • Chen, L.1
  • 35
    • 0036652766 scopus 로고    scopus 로고
    • Acupuncture therapy for the symptoms of Parkinson's disease
    • Shulman LM, Wen X, Weiner WJ, et al. Acupuncture therapy for the symptoms of Parkinson's disease. Mov Disord 2002;17:799-802.
    • (2002) Mov Disord , vol.17 , pp. 799-802
    • Shulman, L.M.1    Wen, X.2    Weiner, W.J.3
  • 36
    • 0034511869 scopus 로고    scopus 로고
    • Upper cervical chiropractic management of a patient with Parkinson's disease: A case report
    • Elster E. Upper cervical chiropractic management of a patient with Parkinson's disease: a case report. J Manipulative Physiol Ther 2000; 23:573-577.
    • (2000) J Manipulative Physiol Ther , vol.23 , pp. 573-577
    • Elster, E.1
  • 37
    • 0032975581 scopus 로고    scopus 로고
    • Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease
    • Wells MR, Giantinoto S, D'Agate D, et al. Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease. J Am Osteopath Assoc 1999;99:92-98.
    • (1999) J Am Osteopath Assoc , vol.99 , pp. 92-98
    • Wells, M.R.1    Giantinoto, S.2    D'Agate, D.3
  • 38
    • 0036764120 scopus 로고    scopus 로고
    • The effect of Trager therapy on the level of evoked stretch responses in patients with Parkinson's disease and rigidity
    • Duval C, Lafontaine D, Hebert J, Leroux A, Panisset M, Boucher JP. The effect of Trager therapy on the level of evoked stretch responses in patients with Parkinson's disease and rigidity. J Manipulative Physiol Ther 2002;25:455-464.
    • (2002) J Manipulative Physiol Ther , vol.25 , pp. 455-464
    • Duval, C.1    Lafontaine, D.2    Hebert, J.3    Leroux, A.4    Panisset, M.5    Boucher, J.P.6
  • 39
    • 0018963726 scopus 로고
    • The response of manual motor functioning in Parkinsonians to frontal EMG biofeedback and progressive relaxation
    • Shumaker RG. The response of manual motor functioning in Parkinsonians to frontal EMG biofeedback and progressive relaxation. Biofeedback Self Regul 1980;5:229-234.
    • (1980) Biofeedback Self Regul , vol.5 , pp. 229-234
    • Shumaker, R.G.1
  • 40
    • 0035262420 scopus 로고    scopus 로고
    • The Alexander technique: Its application in midwifery and the results of preliminary research into Parkinson's
    • Stallibrass C, Hampson M. The Alexander technique: its application in midwifery and the results of preliminary research into Parkinson's. Complementary Ther Nursing Midwifery 2001;7:13-18.
    • (2001) Complementary Ther Nursing Midwifery , vol.7 , pp. 13-18
    • Stallibrass, C.1    Hampson, M.2
  • 41
    • 0031043979 scopus 로고    scopus 로고
    • An evaluation of the Alexander technique for the management of disability in Parkinson's disease: A preliminary study
    • Stallibrass C. An evaluation of the Alexander technique for the management of disability in Parkinson's disease: a preliminary study. Clin Rehabil 1997;11:8-12.
    • (1997) Clin Rehabil , vol.11 , pp. 8-12
    • Stallibrass, C.1
  • 42
    • 0036841857 scopus 로고    scopus 로고
    • Randomized controlled trial of the Alexander technique for Parkinson's disease
    • Stallibrass C, Sissons P, Chalmers C. Randomized controlled trial of the Alexander technique for Parkinson's disease. Clin Rehabil 2002;16: 695-708.
    • (2002) Clin Rehabil , vol.16 , pp. 695-708
    • Stallibrass, C.1    Sissons, P.2    Chalmers, C.3
  • 43
    • 0027527880 scopus 로고
    • Physical rehabilitation in neurology
    • Bohannon R. Physical rehabilitation in neurology. Curr Opin Neurol 1993;6:765-772.
    • (1993) Curr Opin Neurol , vol.6 , pp. 765-772
    • Bohannon, R.1
  • 44
    • 0035068572 scopus 로고    scopus 로고
    • The effect of physical therapy in Parkinson's disease: A research synthesis
    • de Goede C, Keus S, Kwakkel G, Wagenaar R. The effect of physical therapy in Parkinson's disease: a research synthesis. Arch Phys Med Rehabil 2001;82:509-515.
    • (2001) Arch Phys Med Rehabil , vol.82 , pp. 509-515
    • De Goede, C.1    Keus, S.2    Kwakkel, G.3    Wagenaar, R.4
  • 46
    • 0037310587 scopus 로고    scopus 로고
    • Multidisciplinary rehabilitation for people with Parkinson's disease: A randomised controlled study
    • Wade DT, Gage H, Owen C, Trend P, Grossmith C, Kaye J. Multidisciplinary rehabilitation for people with Parkinson's disease: a randomised controlled study. J Neurol Neurosurg Psychiatry 2003;74:158-162.
    • (2003) J Neurol Neurosurg Psychiatry , vol.74 , pp. 158-162
    • Wade, D.T.1    Gage, H.2    Owen, C.3    Trend, P.4    Grossmith, C.5    Kaye, J.6
  • 47
    • 0033814180 scopus 로고    scopus 로고
    • The role of sensory cues in the rehabilitation of parkinsonian patients: A comparison of two physical therapy protocols
    • Marchese R, Diverio M, Zucchi F, Lentino C, Abbruzzese G. The role of sensory cues in the rehabilitation of parkinsonian patients: a comparison of two physical therapy protocols. Mov Disord 2000;15:879-883.
    • (2000) Mov Disord , vol.15 , pp. 879-883
    • Marchese, R.1    Diverio, M.2    Zucchi, F.3    Lentino, C.4    Abbruzzese, G.5
  • 48
    • 0034234249 scopus 로고    scopus 로고
    • Treadmill training with body weight support: Its effect on Parkinson's disease
    • Miyai I, Fujimoto Y, Ueda Y, et al. . Treadmill training with body weight support: its effect on Parkinson's disease. Arch Phys Med Rehabil 2000;81:849-852.
    • (2000) Arch Phys Med Rehabil , vol.81 , pp. 849-852
    • Miyai, I.1    Fujimoto, Y.2    Ueda, Y.3
  • 49
    • 0036790670 scopus 로고    scopus 로고
    • Long-term effect of body weight-supported treadmill training in Parkinson's disease: A randomized controlled trial
    • Miyai I, Fujimoto Y, Yamamoto H, et al. Long-term effect of body weight-supported treadmill training in Parkinson's disease: a randomized controlled trial. Arch Phys Med Rehabil 2002;83:1370-1373.
    • (2002) Arch Phys Med Rehabil , vol.83 , pp. 1370-1373
    • Miyai, I.1    Fujimoto, Y.2    Yamamoto, H.3
  • 50
    • 0041560909 scopus 로고    scopus 로고
    • The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease
    • Hirsch MA, Toole T, Maitland CG, Rider RA. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease. Arch Phys Med Rehabil 2003;84:1109-1117.
    • (2003) Arch Phys Med Rehabil , vol.84 , pp. 1109-1117
    • Hirsch, M.A.1    Toole, T.2    Maitland, C.G.3    Rider, R.A.4
  • 51
    • 0034093075 scopus 로고    scopus 로고
    • Active music therapy in Parkinson's disease: An integrative method for motor and emotional rehabilitation
    • Pacchetti C, Mancini F, Aglieri R, Fundaro C, Martignoni E, Nappi G. Active music therapy in Parkinson's disease: an integrative method for motor and emotional rehabilitation. Psychosom Med 2000;62:386-393.
    • (2000) Psychosom Med , vol.62 , pp. 386-393
    • Pacchetti, C.1    Mancini, F.2    Aglieri, R.3    Fundaro, C.4    Martignoni, E.5    Nappi, G.6
  • 52
    • 33745931465 scopus 로고    scopus 로고
    • Parkinson's disease: Studies in psychological and social care. A targeted physiotherapy service for people with Parkinson's disease from diagnosis to end stage: A pilot study
    • Chandler C, Plant R. Parkinson's disease: studies in psychological and social care. A targeted physiotherapy service for people with Parkinson's disease from diagnosis to end stage: a pilot study. BPS Books 1999;256-279R.
    • (1999) BPS Books
    • Chandler, C.1    Plant, R.2
  • 53
    • 0028215977 scopus 로고
    • Physical therapy and Parkinson's disease: A controlled clinical trial
    • Comella CL, Stebbins GT, Brown-Toms N, Goetz CG. Physical therapy and Parkinson's disease: a controlled clinical trial. Neurology 1994;44: 376-378.
    • (1994) Neurology , vol.44 , pp. 376-378
    • Comella, C.L.1    Stebbins, G.T.2    Brown-Toms, N.3    Goetz, C.G.4
  • 57
    • 0029730734 scopus 로고    scopus 로고
    • Intensive speech treatment for patients with Parkinson's disease: Short- and long-term comparison of two techniques
    • Ramig LO, Countryman S, O'Brien C, Hoehn M, Thompson L. Intensive speech treatment for patients with Parkinson's disease: short- and long-term comparison of two techniques. Neurology 1996;47: 1496-1504.
    • (1996) Neurology , vol.47 , pp. 1496-1504
    • Ramig, L.O.1    Countryman, S.2    O'Brien, C.3    Hoehn, M.4    Thompson, L.5
  • 58
    • 0021745348 scopus 로고
    • Speech therapy in Parkinson's disease: A study of the efficacy and long term effects of intensive treatment
    • Robertson SJ, Thomson F. Speech therapy in Parkinson's disease: a study of the efficacy and long term effects of intensive treatment. Br J Disord Commun 1984;19:213-224.
    • (1984) Br J Disord Commun , vol.19 , pp. 213-224
    • Robertson, S.J.1    Thomson, F.2
  • 59
    • 0025005162 scopus 로고
    • Speech therapy and Parkinson's disease: A review and further data
    • Johnson JA, Pring TR. Speech therapy and Parkinson's disease: a review and further data. Br J Disord Commun 1990;25:183-194.
    • (1990) Br J Disord Commun , vol.25 , pp. 183-194
    • Johnson, J.A.1    Pring, T.R.2
  • 60
    • 0035241252 scopus 로고    scopus 로고
    • Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinson's disease: A comparison with untreated patients and normal age-matched controls
    • Ramig LO, Sapir S, Fox C, Countryman S. Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinson's disease: a comparison with untreated patients and normal age-matched controls. Mov Disord 2001;16:79-83.
    • (2001) Mov Disord , vol.16 , pp. 79-83
    • Ramig, L.O.1    Sapir, S.2    Fox, C.3    Countryman, S.4


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