open access

Vol 53, No 4 (2019)
Research paper
Published online: 2019-08-23
Submitted: 2019-08-23
Accepted: 2019-08-23
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A new therapeutic strategy with istradefylline for postural deformities in Parkinson’s disease

Shinsuke Fujioka, Ryoko Yoshida, Kanako Nose, Yuka Hayashi, Takayasu Mishima, Jiro Fukae, Kosuke Kitano, Hitoshi Kikuchi, Yoshio Tsuboi
DOI: 10.5603/PJNNS.a2019.0036
·
Pubmed: 31441493
·
Neurol Neurochir Pol 2019;53(4):291-295.

open access

Vol 53, No 4 (2019)
Research paper
Published online: 2019-08-23
Submitted: 2019-08-23
Accepted: 2019-08-23

Abstract

Aim of the study. Postural deformities are common in Parkinson’s disease (PD) patients. Several treatment options have been reported, but responses to these treatments appear unpredictable. Istradefylline is a novel drug for PD. Cases of PD patients whose postural deformities were improved after withdrawal of dopamine agonists and initiation of istradefylline are presented. Materials and Methods. Four consecutive patients with postural deformities including antecollis, Pisa syndrome, and camptocormia were recruited and treated with istradefylline in combination with withdrawal of dopamine agonists, which are possible causes of postural deformities. Results. The dopamine agonists were discontinued an average of 26 months after the development of the postural deformities, and istradefylline was initiated an average of 1.3 months after dopamine agonist withdrawal. Three patients with preserved paraspinal muscle volume showed good responses to the treatment regimen at least two months after dopamine agonist withdrawal. Conclusions and clinical Implications. Postural deformities caused by dopamine agonists generally improve less than two weeks after dopamine agonist withdrawal. Given the response time in the present study, the response was unlikely to be caused solely by dopamine agonist withdrawal. Istradefylline can be a potential therapeutic option; however, appropriate selection of patients for treatment with istradefylline is warranted.

Abstract

Aim of the study. Postural deformities are common in Parkinson’s disease (PD) patients. Several treatment options have been reported, but responses to these treatments appear unpredictable. Istradefylline is a novel drug for PD. Cases of PD patients whose postural deformities were improved after withdrawal of dopamine agonists and initiation of istradefylline are presented. Materials and Methods. Four consecutive patients with postural deformities including antecollis, Pisa syndrome, and camptocormia were recruited and treated with istradefylline in combination with withdrawal of dopamine agonists, which are possible causes of postural deformities. Results. The dopamine agonists were discontinued an average of 26 months after the development of the postural deformities, and istradefylline was initiated an average of 1.3 months after dopamine agonist withdrawal. Three patients with preserved paraspinal muscle volume showed good responses to the treatment regimen at least two months after dopamine agonist withdrawal. Conclusions and clinical Implications. Postural deformities caused by dopamine agonists generally improve less than two weeks after dopamine agonist withdrawal. Given the response time in the present study, the response was unlikely to be caused solely by dopamine agonist withdrawal. Istradefylline can be a potential therapeutic option; however, appropriate selection of patients for treatment with istradefylline is warranted.

Get Citation

Keywords

Parkinson’s disease, istradefylline, postural deformity, camptocormia, antecollis, Pisa syndrome

About this article
Title

A new therapeutic strategy with istradefylline for postural deformities in Parkinson’s disease

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 4 (2019)

Pages

291-295

Published online

2019-08-23

DOI

10.5603/PJNNS.a2019.0036

Pubmed

31441493

Bibliographic record

Neurol Neurochir Pol 2019;53(4):291-295.

Keywords

Parkinson’s disease
istradefylline
postural deformity
camptocormia
antecollis
Pisa syndrome

Authors

Shinsuke Fujioka
Ryoko Yoshida
Kanako Nose
Yuka Hayashi
Takayasu Mishima
Jiro Fukae
Kosuke Kitano
Hitoshi Kikuchi
Yoshio Tsuboi

References (11)
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