Objective: To clarify the dopaminergic system link between parkinson’s disease (PD) and oromadibular dystonias (OMDy) co-occur, and the effect of istradefylline (IST) therapy.
Background: OMDy are the subtype of focal dystonia, interfere with several orofacial motor activities such as verbal communication, mastication, swallowing. Spontaneous remission is uncommon, botulinum toxin (BT) is considered to be the first line of treatment, but have not applicable for specific muscle areas. The DBS surgery and some pharmacological approaches have been challenging, but not plausible.
Method: The single-center-prospective open cohort-study were conducted at the department of neurology in Okinawa islands, Japan. The combined incident and prevalent cohort with PD-OMDy were recruited (n=10), idiopathic-OMDy (n=3), MSA-OMDy (n=3) and NB1A-OMDy (n=2). They were followed with open-label treatment in clinical practice from January 2021 to January 2023 for 24 months. The patients were seen ioutpatient clinical setting for neuropsychological evaluation with the global dystonia severity rating scales (MDS-GDS) and MDS-UPDRS. The all cohorts were evaluated with the magnetic resonance imaging, I123-ioflupane dopamine transporter imaging and I123iomazenil benzodiazepine receptor imaging with D-SSP analysis.
Results: The OMDy often present coexisting symptoms, such as limb and truncal dystonia, weight loss, and neuropsychiatric problems. MDS-GDS global score (total 140) of PD-OMDy were 30.2±7.5 (mean±SD), idiopathic-OMDy and MSA-OMDy were 40.7±35.1 and 49.7±16.8, respectively. IST therapy response; marked as⊿changes >10 scores, moderate as 5-10 scores, nil <3 scores, PD-OMDy showed moderate⊿changes with influencing orofacial motor activities of MDS-UPDRS part 2 and 3.
Conclusion: We showed IST moderately attenuate the PD-OMDy but nil for idiopathic and MSA-OMDy, which were impact as tonic inhibitory effect of basal ganglia output of PD-dystonia.
References: Skarmeta NP, et al Orofacial Dystonia and other oromandibular movement disorers. http://dx.doi.org/10.5772/intechopen.78607
To cite this abstract in AMA style:
NAO. Kanzato, SAT. Mochizuki. Istradefylline therapy for PD plus oromandibular dystonia [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/istradefylline-therapy-for-pd-plus-oromandibular-dystonia/. Accessed June 14, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/istradefylline-therapy-for-pd-plus-oromandibular-dystonia/