Atomoxetine for the Treatment of Executive Dysfunction in Parkinson's Disease : A Pilot Open-Label Study
Identifieur interne : 000F75 ( PascalFrancis/Checkpoint ); précédent : 000F74; suivant : 000F76Atomoxetine for the Treatment of Executive Dysfunction in Parkinson's Disease : A Pilot Open-Label Study
Auteurs : Laura Marsh [États-Unis] ; Kevin Biglan [États-Unis] ; Melissa Gerstenhaber [États-Unis] ; James R. Williams [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
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- Pascal (Inist)
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Abstract
Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD-related ED. Twelve patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25-100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression-Change Scale (75% positive response rate; 95% CI: 43-95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.
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Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Biglan, Kevin" sort="Biglan, Kevin" uniqKey="Biglan K" first="Kevin" last="Biglan">Kevin Biglan</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Gerstenhaber, Melissa" sort="Gerstenhaber, Melissa" uniqKey="Gerstenhaber M" first="Melissa" last="Gerstenhaber">Melissa Gerstenhaber</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Williams, James R" sort="Williams, James R" uniqKey="Williams J" first="James R." last="Williams">James R. Williams</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0104584</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0104584 INIST</idno><idno type="RBID">Pascal:09-0104584</idno><idno type="wicri:Area/PascalFrancis/Corpus">000F80</idno><idno type="wicri:Area/PascalFrancis/Curation">001D39</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000F75</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Atomoxetine for the Treatment of Executive Dysfunction in Parkinson's Disease : A Pilot Open-Label Study</title><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Biglan, Kevin" sort="Biglan, Kevin" uniqKey="Biglan K" first="Kevin" last="Biglan">Kevin Biglan</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Gerstenhaber, Melissa" sort="Gerstenhaber, Melissa" uniqKey="Gerstenhaber M" first="Melissa" last="Gerstenhaber">Melissa Gerstenhaber</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Williams, James R" sort="Williams, James R" uniqKey="Williams J" first="James R." last="Williams">James R. Williams</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Atomoxetine</term><term>Cognition</term><term>Cognitive disorder</term><term>Nervous system diseases</term><term>Norepinephrine</term><term>Parkinson disease</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Trouble cognitif</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Atomoxétine</term><term>Traitement</term><term>Cognition</term><term>Noradrénaline</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD-related ED. Twelve patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25-100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression-Change Scale (75% positive response rate; 95% CI: 43-95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>24</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Atomoxetine for the Treatment of Executive Dysfunction in Parkinson's Disease : A Pilot Open-Label Study</s1></fA08><fA11 i1="01" i2="1"><s1>MARSH (Laura)</s1></fA11><fA11 i1="02" i2="1"><s1>BIGLAN (Kevin)</s1></fA11><fA11 i1="03" i2="1"><s1>GERSTENHABER (Melissa)</s1></fA11><fA11 i1="04" i2="1"><s1>WILLIAMS (James R.)</s1></fA11><fA14 i1="01"><s1>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>4 aut.</sZ></fA14><fA20><s1>277-282</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000184195990180</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>32 rfe.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0104584</s0></fA47><fA60><s1>P</s1><s3>CC</s3></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD-related ED. Twelve patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25-100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression-Change Scale (75% positive response rate; 95% CI: 43-95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Trouble cognitif</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Cognitive disorder</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Trastorno cognitivo</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Atomoxétine</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Atomoxetine</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Atomoxetina</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Traitement</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Treatment</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Tratamiento</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Cognition</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Cognition</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Cognición</s0><s5>11</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Noradrénaline</s0><s2>NK</s2><s5>12</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Norepinephrine</s0><s2>NK</s2><s5>12</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Noradrenalina</s0><s2>NK</s2><s5>12</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Catécholamine</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Catecholamine</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Catecolamina</s0><s5>42</s5></fC07><fN21><s1>075</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name></region><name sortKey="Biglan, Kevin" sort="Biglan, Kevin" uniqKey="Biglan K" first="Kevin" last="Biglan">Kevin Biglan</name><name sortKey="Gerstenhaber, Melissa" sort="Gerstenhaber, Melissa" uniqKey="Gerstenhaber M" first="Melissa" last="Gerstenhaber">Melissa Gerstenhaber</name><name sortKey="Gerstenhaber, Melissa" sort="Gerstenhaber, Melissa" uniqKey="Gerstenhaber M" first="Melissa" last="Gerstenhaber">Melissa Gerstenhaber</name><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><name sortKey="Williams, James R" sort="Williams, James R" uniqKey="Williams J" first="James R." last="Williams">James R. 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