Amantadine improves gait in PD patients with STN stimulation.
Identifieur interne : 000E55 ( Main/Exploration ); précédent : 000E54; suivant : 000E56Amantadine improves gait in PD patients with STN stimulation.
Auteurs : Hiu-Fai Chan [Canada] ; Prashanth L. Kukkle ; Marcelo Merello ; Shen-Yang Lim ; Yu-Yan Poon ; Elena MoroSource :
- Parkinsonism & related disorders [ 1873-5126 ] ; 2013.
English descriptors
- KwdEn :
- Adult, Amantadine (therapeutic use), Antiparkinson Agents (administration & dosage), Combined Modality Therapy, Deep Brain Stimulation, Female, Gait (drug effects), Gait Disorders, Neurologic (etiology), Gait Disorders, Neurologic (therapy), Humans, Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (therapy), Subthalamic Nucleus, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents.
- chemical , therapeutic use : Amantadine.
- complications : Parkinson Disease.
- drug effects : Gait.
- etiology : Gait Disorders, Neurologic.
- therapy : Gait Disorders, Neurologic, Parkinson Disease.
- Adult, Combined Modality Therapy, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Subthalamic Nucleus, Treatment Outcome.
Abstract
In advanced Parkinson's disease (PD), axial symptoms such as speech, gait, and balance impairment often become levodopa-unresponsive and they are difficult to manage, even in patients with subthalamic nucleus deep brain stimulation (STN-DBS). We anecdotally observed that oral administration of amantadine was very effective in treating both residual and stimulation-induced axial symptoms after bilateral STN-DBS in one PD patient. Therefore, we conducted a prospective multicenter observational study to evaluate the effects of amantadine on speech, gait and balance in PD patients with STN-DBS and incomplete axial benefit. Primary outcomes were changes in speech (UPDRS III, item 18), gait (item 29) and postural stability (item 30) with amantadine treatment compared to baseline. Secondary outcome was the patients' subjective scoring of axial symptoms with amantadine compared to baseline. Forty-six PD patients with STN-DBS were enrolled in the study and followed for 10.35 ± 8.21 months (median: 9.00; range: 1-31). The mean daily dose of amantadine was 273.44 ± 47.49 mg. Gait scores significantly improved (from 1.51 ± 0.89 to 1.11 ± 0.92, P = 0.015) with amantadine treatment, whereas postural stability and speech scores were similar before and after treatment. Thirty-five (76.1%) patients reported subjective improvement in speech, gait or balance with amantadine, whereas thirty (65.2%) patients reported improvement in gait and balance. In conclusion, our data suggest that amantadine may have new beneficial effects on axial symptoms in PD patients with STN-DBS.
DOI: 10.1016/j.parkreldis.2012.11.005
PubMed: 23218842
Affiliations:
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Kukkle</name></author><author><name sortKey="Merello, Marcelo" sort="Merello, Marcelo" uniqKey="Merello M" first="Marcelo" last="Merello">Marcelo Merello</name></author><author><name sortKey="Lim, Shen Yang" sort="Lim, Shen Yang" uniqKey="Lim S" first="Shen-Yang" last="Lim">Shen-Yang Lim</name></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></author></analytic><series><title level="j">Parkinsonism & related disorders</title><idno type="eISSN">1873-5126</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Amantadine (therapeutic use)</term><term>Antiparkinson Agents (administration & dosage)</term><term>Combined Modality Therapy</term><term>Deep Brain Stimulation</term><term>Female</term><term>Gait (drug effects)</term><term>Gait Disorders, Neurologic (etiology)</term><term>Gait Disorders, Neurologic (therapy)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (therapy)</term><term>Subthalamic Nucleus</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Amantadine</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Gait</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Gait Disorders, Neurologic</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Combined Modality Therapy</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Subthalamic Nucleus</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In advanced Parkinson's disease (PD), axial symptoms such as speech, gait, and balance impairment often become levodopa-unresponsive and they are difficult to manage, even in patients with subthalamic nucleus deep brain stimulation (STN-DBS). We anecdotally observed that oral administration of amantadine was very effective in treating both residual and stimulation-induced axial symptoms after bilateral STN-DBS in one PD patient. Therefore, we conducted a prospective multicenter observational study to evaluate the effects of amantadine on speech, gait and balance in PD patients with STN-DBS and incomplete axial benefit. Primary outcomes were changes in speech (UPDRS III, item 18), gait (item 29) and postural stability (item 30) with amantadine treatment compared to baseline. Secondary outcome was the patients' subjective scoring of axial symptoms with amantadine compared to baseline. Forty-six PD patients with STN-DBS were enrolled in the study and followed for 10.35 ± 8.21 months (median: 9.00; range: 1-31). The mean daily dose of amantadine was 273.44 ± 47.49 mg. Gait scores significantly improved (from 1.51 ± 0.89 to 1.11 ± 0.92, P = 0.015) with amantadine treatment, whereas postural stability and speech scores were similar before and after treatment. Thirty-five (76.1%) patients reported subjective improvement in speech, gait or balance with amantadine, whereas thirty (65.2%) patients reported improvement in gait and balance. In conclusion, our data suggest that amantadine may have new beneficial effects on axial symptoms in PD patients with STN-DBS.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Kukkle, Prashanth L" sort="Kukkle, Prashanth L" uniqKey="Kukkle P" first="Prashanth L" last="Kukkle">Prashanth L. Kukkle</name><name sortKey="Lim, Shen Yang" sort="Lim, Shen Yang" uniqKey="Lim S" first="Shen-Yang" last="Lim">Shen-Yang Lim</name><name sortKey="Merello, Marcelo" sort="Merello, Marcelo" uniqKey="Merello M" first="Marcelo" last="Merello">Marcelo Merello</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Chan, Hiu Fai" sort="Chan, Hiu Fai" uniqKey="Chan H" first="Hiu-Fai" last="Chan">Hiu-Fai Chan</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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