Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: to investigate the effects of bumetanide in Parkinson’s disease (PD) patients suffering from freezing of gait (FOG) resistant to dopamine replacement therapy and subthalamic (STN) DBS.
Background: FOG is one of the disabling complication in PD for which therapeutic options are still limited.A recent experimental study found that bumetanide ,a selective antagonist of the chloride importer NKCCC1,blocks Gigantic GABAergic Currents (GGCs) of the striatal medium spiny GABAergic and subsequently improves motor symptoms in PD animal models(Lozovaya et al.,2018).Open -label observations suggested that Bumetenide might improve FOG in PD(Damier et al.,2016).
Method: Primary outcome measure:change in the number of steps and the completion time during the stand-walk-sit (SWS) test ,performed in OFF and ON-drug stage .Secondary outcome measures: MDS-UPDRS III,Giladi’s questionnaire , patients’ 2 week falls diary,Blood potassium.
Results: Six PD patients treated by STN DBS and suffering from disabling FOG were included (age 61 ± 12 yrs, 4 males, disease duration 23 ± 7 yrs, duration of STN DBS 9.6 ± 2.9 yrs, with good to excellent improvement (CGI-Patient) 1 yr after lead implantation, dopamine replacement treatment 640 ± 310 mg LED .Bumetanide was titrated until 1 mg bid.All patients complained from a polyuria leading two patients to withdraw from the trial. Potassium decreased after 1-month bumetanide treatment (from 3.9 ± 0.3 to 3.6 ± 0.5) without reaching values < 2.5 meq/l.After 3 months of bumetanide treatment: SWS completion time performed in the OFF-drug stage decreased (49.2 ± 23.2 s vs. 61.2 ± 20.6 s at baseline , p=0.03)and gait assessed on the Giladi’s questionnaire improved (7.6 ± 3.5 vs. 14.6 ±1.5). No significant changes on the MDS-UPDRS III in the OFF or ON-drug condition were observed.
Conclusion: This pilot study found that bumetanide improves FOG resistant to dopamine replacement treatment and DBS in PD.These results call for a double-blind placebo controlled study.
To cite this abstract in AMA style:P. Damier, W. Kamel, J. Al Hashel. Bumetanide to treat Parkinson’s disease patients suffering from freezing of gait resistant to both dopamine replacement treatment and subthalamic deep brain stimulation: an open-label pilot study (BumFOG) [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/bumetanide-to-treat-parkinsons-disease-patients-suffering-from-freezing-of-gait-resistant-to-both-dopamine-replacement-treatment-and-subthalamic-deep-brain-stimulation-an-open-label-pilot-st/. Accessed September 28, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/bumetanide-to-treat-parkinsons-disease-patients-suffering-from-freezing-of-gait-resistant-to-both-dopamine-replacement-treatment-and-subthalamic-deep-brain-stimulation-an-open-label-pilot-st/