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进行性核上性麻痹中金刚烷胺使用、步态和认知之间的关联:达武奈肽试验分析

Associations Between Amantadine Usage, Gait, and Cognition in PSP: A Analysis of the Davunetide Trial.

作者信息

Dale Marian L, Brumbach Barbara H, Boxer Adam L, Hiller Amie L

机构信息

Department of Neurology, Oregon Health & Science University, The VA Portland Health Care System, Portland, OR, United States.

Biostatistics and Design Program, Oregon Health & Science University, Portland, OR, United States.

出版信息

Front Neurol. 2020 Dec 21;11:606925. doi: 10.3389/fneur.2020.606925. eCollection 2020.

Abstract

Amantadine anecdotally improves gait in progressive supranuclear palsy (PSP) but definitive data is lacking. We investigated associations between amantadine usage, gait, cognition, and activities of daily living in 310 subjects with PSP using data from the davunetide trial. We compared baseline demographics, PSP Rating Scale (PSPRS), Repeat Battery for the Assessment of Neuropsychological Status (RBANS), and Schwab and England Activities of Daily Living (SEADL) scores between subjects taking vs. not taking amantadine using chi-square tests for categorical variables and independent sample -tests for continuous variables. Using the general linear model (GLM), we tested whether group status predicted total PSPRS, PSPRS-gait and midline, total RBANS, RBANS-attention, and SEADL before and after the 52-weeks follow-up. Subjects taking vs. not taking amantadine were similar at baseline, except subjects taking amantadine had a higher Clinical Global Impression (CGI) Score ( = 0.01). However, the CGI change score did not differ between groups at week 52 ( = 0.10). Using GLM models (controlling for covariates), we found that subjects taking vs. not taking amantadine did not significantly predict total PSPRS, PSPRS-gait and midline, total RBANS, RBANS-attention, or SEADL at baseline, week 52, or the change score between baseline and week 52. This analysis of the davunetide trial did not find an association between amantadine and gait or cognitive measures in PSP, but was not powered to find such a difference. Future studies should still examine amantadine for symptomatic benefit in multiple PSP subtypes.

摘要

金刚烷胺据传闻可改善进行性核上性麻痹(PSP)患者的步态,但缺乏确凿数据。我们利用达武奈肽试验的数据,调查了310例PSP患者中金刚烷胺的使用情况与步态、认知及日常生活活动之间的关联。我们使用卡方检验分析分类变量、独立样本t检验分析连续变量,比较了服用与未服用金刚烷胺的患者之间的基线人口统计学数据、PSP评定量表(PSPRS)、重复神经心理状态评估量表(RBANS)以及施瓦布和英格兰日常生活活动量表(SEADL)得分。使用一般线性模型(GLM),我们测试了在52周随访前后,分组状态是否能预测总PSPRS、PSPRS-步态和中线、总RBANS、RBANS-注意力及SEADL。服用与未服用金刚烷胺的患者在基线时情况相似,只是服用金刚烷胺的患者临床总体印象(CGI)评分更高(P = 0.01)。然而,在第52周时,两组之间的CGI变化评分并无差异(P = 0.10)。使用GLM模型(控制协变量),我们发现服用与未服用金刚烷胺的患者在基线、第52周或基线至第52周的变化评分时,均未显著预测总PSPRS、PSPRS-步态和中线、总RBANS、RBANS-注意力或SEADL。对达武奈肽试验的这项分析未发现金刚烷胺与PSP患者的步态或认知指标之间存在关联,但也没有足够的能力发现这种差异。未来的研究仍应考察金刚烷胺对多种PSP亚型的症状性益处。

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