Mario Giorgio Rizzone1, Francesca Mancini2, Carlo Alberto Artusi3, Roberta Balestrino3,4, Salvatore Bonvegna5, Margherita Fabbri6, Gabriele Imbalzano3, Elisa Montanaro3, Alberto Romagnolo3, Maurizio Zibetti3, Leonardo Lopiano3. 1. Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Via Cherasco, 15, 10124, Torino, Italy. mariogiorgio.rizzone@unito.it. 2. Department of Neurology and Laboratory of Neuroscience, Italian Auxological Institute (IRCCS), Milano, Italy. 3. Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Via Cherasco, 15, 10124, Torino, Italy. 4. Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 5. Parkinson and Movement Disorders Unit, Istituto Neurologico Carlo Besta, Fondazione IRCCS, Milano, Italy. 6. Clinical Investigation Center CIC1436, Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Centre and NeuroToul Center of Excellence in Neurodegeneration (COEN) of Toulouse, INSERM, University of Toulouse 3, CHU of Toulouse, Toulouse, France.
Abstract
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective surgical treatment for advanced Parkinson's disease (PD). However, some patients still experience motor fluctuations or dyskinesia after STN-DBS. Safinamide is approved as add-on treatment to levodopa in fluctuating PD patients. In this study, we evaluated the effect of safinamide as adjunctive therapy in PD patients still experiencing motor fluctuations and dyskinesias after STN-DBS. METHODS: PD patients treated for at least 2 years with bilateral STN-DBST and with troublesome motor fluctuation and/or dyskinesias were examined by means of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the quality of life questionnaire Parkinson's Disease Questionnaire-8 (PDQ-8) and the Non-Motor Symptoms Scale (NMSS) at baseline (T0), after 1 month of treatment with safinamide 50 mg daily (T1) and after another month of treatment with safinamide 100 mg daily (T2). RESULTS: Twenty-nine PD patients were examined. An improvement of the MDS-UPDRS IV score (motor complications) was observed between T0 and T1, T0 and T2, and T1 and T2. The time spent in the OFF state, the functional impact and the complexity of motor fluctuations significantly improved between T0 and T1 and T0 and T2. The mean levodopa equivalent daily dose significantly decreased from T0 to T1 and from T0 to T2. Regarding non-motor symptoms, an improvement on mood and pain was observed. CONCLUSIONS: Safinamide seems to be an effective adjunctive treatment in PD patients treated with bilateral STN-DBS, leading to an improvement of motor complications, mood and pain.
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective surgical treatment for advanced Parkinson's disease (PD). However, some patients still experience motor fluctuations or dyskinesia after STN-DBS. Safinamide is approved as add-on treatment to levodopa in fluctuating PD patients. In this study, we evaluated the effect of safinamide as adjunctive therapy in PD patients still experiencing motor fluctuations and dyskinesias after STN-DBS. METHODS: PD patients treated for at least 2 years with bilateral STN-DBST and with troublesome motor fluctuation and/or dyskinesias were examined by means of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the quality of life questionnaire Parkinson's Disease Questionnaire-8 (PDQ-8) and the Non-Motor Symptoms Scale (NMSS) at baseline (T0), after 1 month of treatment with safinamide 50 mg daily (T1) and after another month of treatment with safinamide 100 mg daily (T2). RESULTS: Twenty-nine PD patients were examined. An improvement of the MDS-UPDRS IV score (motor complications) was observed between T0 and T1, T0 and T2, and T1 and T2. The time spent in the OFF state, the functional impact and the complexity of motor fluctuations significantly improved between T0 and T1 and T0 and T2. The mean levodopa equivalent daily dose significantly decreased from T0 to T1 and from T0 to T2. Regarding non-motor symptoms, an improvement on mood and pain was observed. CONCLUSIONS: Safinamide seems to be an effective adjunctive treatment in PD patients treated with bilateral STN-DBS, leading to an improvement of motor complications, mood and pain.
Authors: M G Rizzone; A Fasano; A Daniele; M Zibetti; A Merola; L Rizzi; C Piano; C Piccininni; L M Romito; L Lopiano; A Albanese Journal: Parkinsonism Relat Disord Date: 2014-01-23 Impact factor: 4.891
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Authors: Rupam Borgohain; J Szasz; P Stanzione; C Meshram; M Bhatt; D Chirilineau; F Stocchi; V Lucini; R Giuliani; E Forrest; P Rice; R Anand Journal: Mov Disord Date: 2013-12-09 Impact factor: 10.338
Authors: Carsten Buhmann; Torge Huckhagel; Katja Engel; Alessandro Gulberti; Ute Hidding; Monika Poetter-Nerger; Ines Goerendt; Peter Ludewig; Hanna Braass; Chi-Un Choe; Kara Krajewski; Christian Oehlwein; Katrin Mittmann; Andreas K Engel; Christian Gerloff; Manfred Westphal; Johannes A Köppen; Christian K E Moll; Wolfgang Hamel Journal: PLoS One Date: 2017-07-05 Impact factor: 3.240