Olson W L, Gruenthal M, Mueller M E, Olson W H
Department of Neurology, University of Louisville, Kentucky 40292, USA.
Am J Med. 1997 Jan;102(1):60-6. doi: 10.1016/s0002-9343(96)00381-6.
Gabapentin is a recently available anticonvulsant whose mechanism of action remains unknown. We suspected efficacy from serendipitous observations of gabapentin in patients with parkinsonism. This led us to a double-blind, placebo-controlled, crossover trial.
We administered gabapentin in a placebo-controlled, double-blind, crossover trial to 19 subjects with advanced parkinsonism. We measured the effect of placebo and gabapentin on subjects' symptoms with the Unified Parkinson's Disease Rating Scale, the Webster Scale, and the Hoehn and Yahr Scale. We assessed tremor with surface-recorded electromyography.
Total Unified Parkinson's Disease Rating Scale improved with gabapentin compared with placebo (P = 0.0005). Likewise, activities of daily living and examination subscore of the Unified Parkinson's Disease Rating Scale improved with gabapentin compared with placebo but did not achieve statistical significance. Webster Scale showed improvement but neither Hoehn and Yahr Scale nor Webster Scale changes reached statistical significance. Tremor as measured by the Unified Parkinson's Disease Rating Scale improved with gabapentin but the use of the root mean square of the rectified electromyography as a measure of tremor activity was not statistically significant.
This study demonstrates that gabapentin improves rigidity, bradykinesia, and tremor of parkinsonism including both Parkinson's disease and Parkinson's syndrome. The rigidity and bradykinesia of parkinsonism improve on the drug even when the effects of gabapentin on tremor are discounted.
加巴喷丁是一种新近可用的抗惊厥药，其作用机制尚不清楚。我们从帕金森病患者使用加巴喷丁的意外观察中怀疑其疗效。这促使我们进行了一项双盲、安慰剂对照的交叉试验。
我们在一项安慰剂对照、双盲、交叉试验中，对19名晚期帕金森病患者给予加巴喷丁。我们用统一帕金森病评定量表、韦伯斯特量表以及霍恩和雅尔量表来测量安慰剂和加巴喷丁对受试者症状的影响。我们通过表面记录肌电图评估震颤情况。
与安慰剂相比，加巴喷丁使统一帕金森病评定量表总分有所改善（P = 0.0005）。同样，与安慰剂相比，加巴喷丁使统一帕金森病评定量表的日常生活活动和检查子评分有所改善，但未达到统计学显著性。韦伯斯特量表显示有改善，但霍恩和雅尔量表以及韦伯斯特量表的变化均未达到统计学显著性。统一帕金森病评定量表所测量的震颤情况在加巴喷丁治疗后有所改善，但用整流肌电图的均方根作为震颤活动的测量指标时，差异无统计学显著性。
本研究表明，加巴喷丁可改善帕金森病（包括帕金森病和帕金森综合征）的强直、运动迟缓及震颤。即使不考虑加巴喷丁对震颤的影响，帕金森病的强直和运动迟缓在使用该药物后也有所改善。
