Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson’s disease
Identifieur interne : 002703 ( Main/Exploration ); précédent : 002702; suivant : 002704Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson’s disease
Auteurs : D. Devos [France] ; P. Krystkowiak [France] ; F. Clement [France] ; K. Dujardin [France] ; O. Cottencin [France] ; N. Waucquier [France] ; K. Ajebbar [France] ; B. Thielemans [France] ; M. Kroumova [France] ; A. Duhamel [France] ; A. Destée [France] ; R. Bordet [France] ; L. Defebvre [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2007-05.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- ADHD, attention-deficit hyperactivity disorder, Advanced stage, Aged, Central Nervous System Stimulants (therapeutic use), Chronic, DAT, dopamine transporter, Dose-Response Relationship, Drug, Fatigue, Female, Gait Disorders, Neurologic (drug therapy), Gait Disorders, Neurologic (etiology), High dose, Human, Humans, Improvement, MADRS, Montgomery Asberg Depression Rating Scale, MPD, methylphenidate, Male, Methylphenidate, Methylphenidate (therapeutic use), Middle Aged, Nervous system diseases, PD, Parkinson’s disease, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson disease, STN, subthalamic nucleus, SWS, Stand–Walk–Sit, Severity of Illness Index, Single-Blind Method, Treatment Outcome, UPDRS, Unified Parkinson’s Disease Rating Scale.
- MESH :
- chemical , therapeutic use : Central Nervous System Stimulants, Methylphenidate.
- complications : Parkinson Disease.
- drug therapy : Gait Disorders, Neurologic, Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- Aged, Dose-Response Relationship, Drug, Fatigue, Female, Humans, Male, Middle Aged, Severity of Illness Index, Single-Blind Method, Treatment Outcome.
Abstract
Background: Therapeutic management of gait disorders in patients with advanced Parkinson’s disease (PD) can sometimes be disappointing, since dopaminergic drug treatments and subthalamic nucleus (STN) stimulation are more effective for limb-related parkinsonian signs than for gait disorders. Gait disorders could also be partly related to norepinephrine system impairment, and the pharmacological modulation of both dopamine and norepinephrine pathways could potentially improve the symptomatology. Aim: To assess the clinical value of chronic, high doses of methylphenidate (MPD) in patients with PD having gait disorders, despite their use of optimal dopaminergic doses and STN stimulation parameters. Methods: Efficacy was blindly assessed on video for 17 patients in the absence of l-dopa and again after acute administration of the drug, both before and after a 3-month course of MPD, using a Stand–Walk–Sit (SWS) Test, the Tinetti Scale, the Unified Parkinson’s Disease Rating Scale (UPDRS) part III score and the Dyskinesia Rating Scale. Results: An improvement was observed in the number of steps and time in the SWS Test, the number of freezing episodes, the Tinetti Scale score and the UPDRS part III score in the absence of l-dopa after 3 months of taking MPD. The l-dopa-induced improvement in these various scores was also stronger after the 3-month course of MPD than before. The Epworth Sleepiness Scale score fell dramatically in all patients. No significant induction of adverse effects was found. Interpretation: Chronic, high doses of MPD improved gait and motor symptoms in the absence of l-dopa and increased the intensity of response of these symptoms to l-dopa in a population with advanced PD.
Url:
- https://api.istex.fr/document/CABCC9CC2B642464CAA14559B878956FC93B2229/fulltext/pdf
- https://hal.archives-ouvertes.fr/hal-00337015
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2117830
DOI: 10.1136/jnnp.2006.100016
Affiliations:
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Le document en format XML
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Devos</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Krystkowiak, P" sort="Krystkowiak, P" uniqKey="Krystkowiak P" first="P" last="Krystkowiak">P. 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Dujardin</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Cottencin, O" sort="Cottencin, O" uniqKey="Cottencin O" first="O" last="Cottencin">O. Cottencin</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Psychiatry, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Waucquier, N" sort="Waucquier, N" uniqKey="Waucquier N" first="N" last="Waucquier">N. Waucquier</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Ajebbar, K" sort="Ajebbar, K" uniqKey="Ajebbar K" first="K" last="Ajebbar">K. Ajebbar</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Pharmacy, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Thielemans, B" sort="Thielemans, B" uniqKey="Thielemans B" first="B" last="Thielemans">B. Thielemans</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Pharmacy, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Kroumova, M" sort="Kroumova, M" uniqKey="Kroumova M" first="M" last="Kroumova">M. Kroumova</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Clinical Investigation Centre, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Duhamel, A" sort="Duhamel, A" uniqKey="Duhamel A" first="A" last="Duhamel">A. Duhamel</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Biostatistics, Faculty of Medicine, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Destee, A" sort="Destee, A" uniqKey="Destee A" first="A" last="Destée">A. 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Bordet</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Pharmacology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Defebvre, L" sort="Defebvre, L" uniqKey="Defebvre L" first="L" last="Defebvre">L. Defebvre</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Institute of Predictive Medicine and Therapeutic Research, Lille University Medical Centre, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2007-05">2007-05</date><biblScope unit="volume">78</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="470">470</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">CABCC9CC2B642464CAA14559B878956FC93B2229</idno><idno type="DOI">10.1136/jnnp.2006.100016</idno><idno type="href">jnnp-78-470.pdf</idno><idno type="PMID">17098845</idno><idno type="local">0780470</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ADHD, attention-deficit hyperactivity disorder</term><term>Advanced stage</term><term>Aged</term><term>Central Nervous System Stimulants (therapeutic use)</term><term>Chronic</term><term>DAT, dopamine transporter</term><term>Dose-Response Relationship, Drug</term><term>Fatigue</term><term>Female</term><term>Gait Disorders, Neurologic (drug therapy)</term><term>Gait Disorders, Neurologic (etiology)</term><term>High dose</term><term>Human</term><term>Humans</term><term>Improvement</term><term>MADRS, Montgomery Asberg Depression Rating Scale</term><term>MPD, methylphenidate</term><term>Male</term><term>Methylphenidate</term><term>Methylphenidate (therapeutic use)</term><term>Middle Aged</term><term>Nervous system diseases</term><term>PD, Parkinson’s disease</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson disease</term><term>STN, subthalamic nucleus</term><term>SWS, Stand–Walk–Sit</term><term>Severity of Illness Index</term><term>Single-Blind Method</term><term>Treatment Outcome</term><term>UPDRS, Unified Parkinson’s Disease Rating Scale</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Central Nervous System Stimulants</term><term>Methylphenidate</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Gait Disorders, Neurologic</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Dose-Response Relationship, Drug</term><term>Fatigue</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Single-Blind Method</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Amélioration</term><term>Chronique</term><term>Dose forte</term><term>Homme</term><term>Méthylphénidate</term><term>Parkinson maladie</term><term>Stade avancé</term><term>Système nerveux pathologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Therapeutic management of gait disorders in patients with advanced Parkinson’s disease (PD) can sometimes be disappointing, since dopaminergic drug treatments and subthalamic nucleus (STN) stimulation are more effective for limb-related parkinsonian signs than for gait disorders. Gait disorders could also be partly related to norepinephrine system impairment, and the pharmacological modulation of both dopamine and norepinephrine pathways could potentially improve the symptomatology. Aim: To assess the clinical value of chronic, high doses of methylphenidate (MPD) in patients with PD having gait disorders, despite their use of optimal dopaminergic doses and STN stimulation parameters. Methods: Efficacy was blindly assessed on video for 17 patients in the absence of l-dopa and again after acute administration of the drug, both before and after a 3-month course of MPD, using a Stand–Walk–Sit (SWS) Test, the Tinetti Scale, the Unified Parkinson’s Disease Rating Scale (UPDRS) part III score and the Dyskinesia Rating Scale. Results: An improvement was observed in the number of steps and time in the SWS Test, the number of freezing episodes, the Tinetti Scale score and the UPDRS part III score in the absence of l-dopa after 3 months of taking MPD. The l-dopa-induced improvement in these various scores was also stronger after the 3-month course of MPD than before. The Epworth Sleepiness Scale score fell dramatically in all patients. No significant induction of adverse effects was found. Interpretation: Chronic, high doses of MPD improved gait and motor symptoms in the absence of l-dopa and increased the intensity of response of these symptoms to l-dopa in a population with advanced PD.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Hauts-de-France</li><li>Nord-Pas-de-Calais</li></region><settlement><li>Lille</li></settlement></list><tree><country name="France"><region name="Hauts-de-France"><name sortKey="Devos, D" sort="Devos, D" uniqKey="Devos D" first="D" last="Devos">D. Devos</name></region><name sortKey="Ajebbar, K" sort="Ajebbar, K" uniqKey="Ajebbar K" first="K" last="Ajebbar">K. Ajebbar</name><name sortKey="Bordet, R" sort="Bordet, R" uniqKey="Bordet R" first="R" last="Bordet">R. Bordet</name><name sortKey="Clement, F" sort="Clement, F" uniqKey="Clement F" first="F" last="Clement">F. Clement</name><name sortKey="Cottencin, O" sort="Cottencin, O" uniqKey="Cottencin O" first="O" last="Cottencin">O. Cottencin</name><name sortKey="Defebvre, L" sort="Defebvre, L" uniqKey="Defebvre L" first="L" last="Defebvre">L. Defebvre</name><name sortKey="Destee, A" sort="Destee, A" uniqKey="Destee A" first="A" last="Destée">A. Destée</name><name sortKey="Duhamel, A" sort="Duhamel, A" uniqKey="Duhamel A" first="A" last="Duhamel">A. Duhamel</name><name sortKey="Dujardin, K" sort="Dujardin, K" uniqKey="Dujardin K" first="K" last="Dujardin">K. Dujardin</name><name sortKey="Kroumova, M" sort="Kroumova, M" uniqKey="Kroumova M" first="M" last="Kroumova">M. Kroumova</name><name sortKey="Krystkowiak, P" sort="Krystkowiak, P" uniqKey="Krystkowiak P" first="P" last="Krystkowiak">P. Krystkowiak</name><name sortKey="Thielemans, B" sort="Thielemans, B" uniqKey="Thielemans B" first="B" last="Thielemans">B. Thielemans</name><name sortKey="Waucquier, N" sort="Waucquier, N" uniqKey="Waucquier N" first="N" last="Waucquier">N. Waucquier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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