Objective: To clarify the basal ganglia network links between PD and Dystonia in PD (Dys-PD) co-occur, and to get the conceptually novel pharmacotherapy.
Background: Dys-PD is one of the cardinal PD symptoms, occurs in pre-L-Dopa era, or L-Dopa associated; off dystonia, at the onset or off-set benefit. The L-Dopa and some pharmacological approaches have been challenging for Dys-PD, but not plausible.
Method: The single-center-prospective open cohort-study was conducted at the department of neurology in Okinawa islands, Japan. The cohort with PD (n=227), hereditary dystonia
(androgen receptor/SBMA, GNAO1/G protein linked dystonia, PRKN/park2, n=3) were recruited from April 2022 to March 2024 (2 years). The patients were followed with open-label treatment in clinical practice, and evaluated with the global dystonia severity rating scales (MDS-GDS) and MDS-UPDRS part 3 and 4. The cohorts with newly appeared Dys-PD were evaluated with I123iomazenil benzodiazepine receptor imaging.
Results: The frequency rate (%) of newly or amplified Dys-PD were 41.7, and each subtype as follows; blepharospasm/oromandibular 12.3, limb 12.8, camptocormia/PISA/neck 17.6. The Dys-PD were partially resolved with the interventions. Therapeutic effect by decrease (Δ) of GDS scales were LD, -2.84±6.97; IST, -8.0±6.74; ZNS, -7.6±6.64, BTX, -5.9±4.48, DBS, -4,3±3.5 (mean ±SD). I123iomazenil benzodiazepine receptor imaging revealed asymmetry difference, and decreased uptake in the temporal to parietal areas (association cortex) and diencephalon to brainstem.
Conclusion: We showed IST partially attenuate the Dys-PD, with restoring the GPe driving on the basal ganglia output.1)2) Dys-PD contain the myriad of etiology, correct diagnosis by
phenomenology and challenging with the intervention may be important.
References: 1) Mori A, et al. Molecules 2022, 27, 2366.doi.10.3390.
2) Jie Dong, et al. Front Neural Circuit 2021, doi.10.3359.
To cite this abstract in AMA style:
NAO. Kanzato, KOH. Nakachi, SAT. Mochizuki,. Istradefylline therapy for dystonia in Parkinson’s disease [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/istradefylline-therapy-for-dystonia-in-parkinsons-disease/. Accessed June 15, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/istradefylline-therapy-for-dystonia-in-parkinsons-disease/