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Effects of augmenting cholinergic neurotransmission on balance in Parkinson's disease.
- Source :
-
Parkinsonism & Related Disorders . Dec2019, Vol. 69, p40-47. 8p. - Publication Year :
- 2019
-
Abstract
- <bold>Introduction: </bold>Degeneration of cholinergic systems may contribute to impairments of balance and gait in Parkinson's disease (PD) and phase 2 clinical trials have suggested that centrally acting cholinesterase inhibitors reduce falls. Here, we examined the effects of augmenting cholinergic neurotransmission on static and dynamic balance, indices of fall risk.<bold>Methods: </bold>A single-site, randomized, double-blind, crossover trial examined the effect of donepezil in patients with PD. Forty-nine participants with idiopathic PD were randomized and 45 completed the trial. Each treatment period was 6 weeks with a 6-week washout between treatments. Donepezil in 2.5 mg capsules, or identical appearing placebo capsules, was increased from two per day (5 mg) to four capsules (10 mg) after 3 weeks. The primary outcome measures were the range of the medio-lateral sway when standing (static balance) and the variability of the stride duration when walking (dynamic balance). A linear mixed model was used to investigate whether the change in outcomes between weeks 0 and 6 differed between phases.<bold>Results: </bold>There were no significant differences in treatment effects between placebo and donepezil for medio-lateral sway range during quiet standing (p = 0.28), nor in gait variability (p = 0.31). None of the secondary outcome measures or exploratory analyses were significant although one secondary measure of static balance was increased by donepezil.<bold>Conclusions: </bold>Contrary to our hypothesis, cholinergic augmentation with donepezil at 10 mg/day for 6 weeks did not affect measures of static or dynamic balance in people with PD. These results are compared with other phase 2 trials of cholinesterase inhibitors and considerations for future trials are discussed. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13538020
- Volume :
- 69
- Database :
- Academic Search Index
- Journal :
- Parkinsonism & Related Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 140094558
- Full Text :
- https://doi.org/10.1016/j.parkreldis.2019.10.022