Djaldetti R, Ziv I, Melamed E
Department of Neurology and the Felsenstein Research Center, Rabin Medical Center, Beilinson Campus, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Neural Transm (Vienna). 2002 May;109(5-6):797-803. doi: 10.1007/s007020200066.
Deprenyl, an irreversible MAO-B inhibitor, is known to have a symptomatic effect in de novo patients with Parkinson's disease (PD). It has, however, not been studied thoroughly in patients with advanced PD and response fluctuations. This study evaluated the effect of washout of deprenyl in patients with long-standing PD. Eleven PD patients who were on chronic treatment with deprenyl (mean age 57 +/- 8 years, mean disease duration 8.4 +/- 2.9 years), seven with response fluctuations, were enrolled in a double-blind study of a novel MAO-B inhibitor. A deprenyl washout period of one month was required prior to initiation of treatment with the trial drug. Patients were evaluated by Unified Parkinson's Disease Rating scale (UPDRS) before and one month after the washout period. Motor function was quantified by computerized tapping speed and movement time test. Results showed that neither total UPDRS scores (22 +/- 16 vs. 18 +/- 16, respectively) nor tapping speed and movement time changed significantly (4.4 +/- 0.5 vs. 4.2 +/- 0.3 Hz and 159 +/- 45 vs. 161 +/- 40 seconds; p > 0.1, respectively). However, eight patients reported various degrees of subjective deterioration, among them were the seven fluctuating patients. Two patients first began to experience response fluctuations during the washout period. It seems that deprenyl has a symptomatic effect, especially in patients with response fluctuations, and it may postpone the appearance of fluctuations in patients with PD. Attempts to discontinue treatment with deprenyl may aggravate disease symptoms.
司来吉兰是一种不可逆的单胺氧化酶B（MAO-B）抑制剂，已知其对帕金森病（PD）初发患者有症状改善作用。然而，对于晚期PD和症状波动患者，尚未进行充分研究。本研究评估了司来吉兰洗脱期对长期患PD患者的影响。11例长期接受司来吉兰治疗的PD患者（平均年龄57±8岁，平均病程8.4±2.9年），其中7例有症状波动，被纳入一项新型MAO-B抑制剂的双盲研究。在开始试验药物治疗前，需要有一个月的司来吉兰洗脱期。在洗脱期前后，通过统一帕金森病评定量表（UPDRS）对患者进行评估。通过计算机化敲击速度和运动时间测试对运动功能进行量化。结果显示，UPDRS总分（分别为22±16和18±16）、敲击速度和运动时间均无显著变化（分别为4.4±0.5与4.2±0.3Hz以及159±45与161±40秒；p>0.1）。然而，8例患者报告了不同程度的主观恶化，其中包括7例有症状波动的患者。2例患者在洗脱期首次开始出现症状波动。司来吉兰似乎有症状改善作用，尤其是对有症状波动的患者，并且它可能会推迟PD患者症状波动的出现。停用司来吉兰的尝试可能会加重疾病症状。
