open access
A new therapeutic strategy with istradefylline for postural deformities in Parkinson’s disease
Affiliations- Department of Neurology, Murakami Karindoh Hospital, Fukuoka, Japan
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
- Department of Internal Medicine, Murakami Karindoh Hospital, Fukuoka, Japan
- Department of Rehabilitation, Murakami Karindoh Hospital, Fukuoka, Japan
open access
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.
Keywords
Parkinson’s disease, istradefylline, postural deformity, camptocormia, antecollis, Pisa syndrome
About this articleTitle
A new therapeutic strategy with istradefylline for postural deformities in Parkinson’s disease
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
291-295
Published online
2019-08-23
Page views
2084
Article views/downloads
1404
DOI
Pubmed
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)- Doherty KM, van de Warrenburg BP, Peralta MC, et al. Postural deformities in Parkinson's disease. Lancet Neurol. 2011; 10(6): 538–549.
- Margraf NG, Wrede A, Deuschl G, et al. Pathophysiological Concepts and Treatment of Camptocormia. J Parkinsons Dis. 2016; 6(3): 485–501.
- Pourcher E, Fernandez HH, Stacy M, et al. Istradefylline for Parkinson's disease patients experiencing motor fluctuations: results of the KW-6002-US-018 study. Parkinsonism Relat Disord. 2012; 18(2): 178–184.
- Fernandez HH, Greeley DR, Zweig RM, et al. 6002-US-051 Study Group. Istradefylline as monotherapy for Parkinson disease: results of the 6002-US-051 trial. Parkinsonism Relat Disord. 2010; 16(1): 16–20.
- Suzuki K, Miyamoto T, Miyamoto M, et al. Could istradefylline be a treatment option for postural abnormalities in mid-stage Parkinson's disease? J Neurol Sci. 2018; 385: 131–133.
- Kataoka H, Sugie K. Does istradefylline really have a dystonic mechanism? J Neurol Sci. 2018; 388: 233–234.
- Mizuno Y, Kondo T. Japanese Istradefylline Study Group. Adenosine A2A receptor antagonist istradefylline reduces daily OFF time in Parkinson's disease. Mov Disord. 2013; 28(8): 1138–1141.
- Hughes AJ, Daniel SE, Kilford L, et al. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992; 55(3): 181–184.
- Sakai W, Nakane S, Urasaki E, et al. The Cross-Sectional Area of Paraspinal Muscles Predicts the Efficacy of Deep Drain Stimulation for Camptocormia. J Parkinsons Dis. 2017; 7(2): 247–253.
- Napolitano F, Pasqualetti M, Usiello A, et al. Dopamine D2 receptor dysfunction is rescued by adenosine A2A receptor antagonism in a model of DYT1 dystonia. Neurobiol Dis. 2010; 38(3): 434–445.
- Takakusaki K, Saitoh K, Harada H, et al. Role of basal ganglia-brainstem pathways in the control of motor behaviors. Neurosci Res. 2004; 50(2): 137–151.
