Atomoxetine for the treatment of executive dysfunction in Parkinson’s disease
Identifieur interne : 000043 ( Pmc/Curation ); précédent : 000042; suivant : 000044Atomoxetine for the treatment of executive dysfunction in Parkinson’s disease
Auteurs : Laura Marsh [États-Unis] ; Kevin Biglan [États-Unis] ; Melissa Gerstenhaber [États-Unis] ; James R. Williams [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2009.
Abstract
Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson’s 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.
12 patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25 to 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.
Url:
DOI: 10.1002/mds.22307
PubMed: 19025777
PubMed Central: 2683743
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Kevin Biglan<affiliation><nlm:aff id="A5">Department of Neurology, University of Rochester Medical School</nlm:aff>
<wicri:noCountry code="subfield">University of Rochester Medical School</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Introduction</title>
<p id="P2">Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson’s 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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P3">12 patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25 to 100 mg/day) trial of atomoxetine.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">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.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610688</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5937</journal-id>
<journal-id journal-id-type="nlm-ta">Mov Disord</journal-id>
<journal-title>Movement disorders : official journal of the Movement Disorder Society</journal-title>
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<article-id pub-id-type="doi">10.1002/mds.22307</article-id>
<article-id pub-id-type="manuscript">NIHMS106386</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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</article-categories>
<title-group><article-title>Atomoxetine for the treatment of executive dysfunction in Parkinson’s disease</article-title>
<subtitle>A pilot open-label study</subtitle>
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<contrib-group><contrib contrib-type="author"><name><surname>Marsh</surname>
<given-names>Laura</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
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<contrib contrib-type="author"><name><surname>Biglan</surname>
<given-names>Kevin</given-names>
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<degrees>M.D., M.P.H.</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A5">5</xref>
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<contrib contrib-type="author"><name><surname>Gerstenhaber</surname>
<given-names>Melissa</given-names>
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<degrees>M.A.S, M.S.N.</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
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<contrib contrib-type="author"><name><surname>Williams</surname>
<given-names>James R.</given-names>
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<degrees>M.H.S.</degrees>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
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<aff id="A1"><label>1</label>
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</aff>
<aff id="A2"><label>2</label>
Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</aff>
<aff id="A3"><label>3</label>
Morris K. Udall Parkinson’s Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD, USA</aff>
<aff id="A4"><label>4</label>
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA</aff>
<aff id="A5"><label>5</label>
Department of Neurology, University of Rochester Medical School</aff>
<author-notes><corresp id="CR1">Correspondence to: Laura Marsh, M.D., Johns Hopkins University School of Medicine, 600 N. Wolfe Street- Phipps 300, Baltimore, MD 21287, <email>lmarsh@jhmi.edu</email>
; o:410-502-6945; f: 410-614-3676</corresp>
<fn id="FN1"><p id="P1">The authors confirm that this work complies with the Movement Disorder Society’s policy on ghostwriting.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>9</day>
<month>4</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>30</day>
<month>1</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>30</day>
<month>1</month>
<year>2010</year>
</pub-date>
<volume>24</volume>
<issue>2</issue>
<fpage>277</fpage>
<lpage>282</lpage>
<abstract><sec id="S1"><title>Introduction</title>
<p id="P2">Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson’s 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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P3">12 patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25 to 100 mg/day) trial of atomoxetine.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">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.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.</p>
</sec>
</abstract>
<kwd-group><kwd>Executive Dysfunction</kwd>
<kwd>Parkinson’s disease</kwd>
<kwd>Cognition</kwd>
<kwd>Norepinephrine Reuptake inhibition</kwd>
<kwd>Atomoxetine</kwd>
</kwd-group>
<contract-num rid="RR1">UL1 RR025005-01</contract-num>
<contract-num rid="AG1">T32 AG027668-02</contract-num>
<contract-num rid="NS1">P50 NS038377-10</contract-num>
<contract-sponsor id="RR1">National Center for Research Resources : NCRR</contract-sponsor>
<contract-sponsor id="AG1">National Institute on Aging : NIA</contract-sponsor>
<contract-sponsor id="NS1">National Institute of Neurological Disorders and Stroke : NINDS</contract-sponsor>
</article-meta>
</front>
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