Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
J Neurol Sci. 2018 Feb 15;385:131-133. doi: 10.1016/j.jns.2017.12.027. Epub 2017 Dec 24.
Postural abnormalities are refractory complications observed in mid- to late-stage Parkinson's disease (PD).
We analyzed the effects of istradefylline, a selective adenosine A2A receptor antagonist, on posture in 21 levodopa-treated PD patients from the subanalysis of a three-month open-label study.
The subitem score of posture (3.13) on the Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III significantly improved following istradefylline treatment (baseline, 1.3±1.0 points vs 3months, 0.9±0.9 points; p<0.05). Among 18 patients who had postural abnormalities at baseline, defined as 1 point or greater on MDS-UPDRS part III subitem 3.13, posture improved in 9 (50%) and was unchanged in 9 (50%) patients after istradefylline treatment. Improved and unchanged groups did not show differences in baseline characteristics, except for tendency for a higher rate of Hoehn and Yahr stage IV and V (Off state) observed in the improved group. Changes in scores of posture (3.13) did not correlate with those of other MDS-UPDRS part III items, PD Questionnaire-8, PD Sleep Scale-2 and Epworth Sleepiness Scale.
Based on our preliminary findings, istradefylline could be an effective treatment option for postural abnormalities in mid-stage PD patients.
姿势异常是中晚期帕金森病（PD）观察到的难治性并发症。
我们分析了选择性腺苷 A2A 受体拮抗剂伊曲茶碱对 21 名接受左旋多巴治疗的 PD 患者的姿势的影响，这是一项为期三个月的开放标签研究的亚分析。
运动障碍协会帕金森病评定量表第三部分（MDS-UPDRS）的姿势亚项评分（3.13）在伊曲茶碱治疗后显著改善（基线，1.3±1.0 分与 3 个月，0.9±0.9 分；p<0.05）。在基线时有姿势异常的 18 名患者中（MDS-UPDRS 第三部分 3.13 亚项为 1 分或更高），伊曲茶碱治疗后 9 名（50%）患者的姿势改善，9 名（50%）患者的姿势无变化。改善组和无变化组在基线特征方面没有差异，除了改善组观察到更高的 Hoehn 和 Yahr 分期 IV 和 V（关闭状态）的趋势。姿势（3.13）评分的变化与 MDS-UPDRS 第三部分的其他项目、帕金森病问卷-8、帕金森病睡眠量表-2 和 Epworth 嗜睡量表的评分变化无关。
根据我们的初步发现，伊曲茶碱可能是中晚期 PD 患者姿势异常的有效治疗选择。
