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J Neurol Neurosurg Psychiatry 84:552-555 doi:10.1136/jnnp-2012-303182
  • Movement disorders
  • Short report

Memantine for axial signs in Parkinson's disease: a randomised, double-blind, placebo-controlled pilot study

Open Access
  1. David Devos1,2,9
  1. 1Department of Neurology, University of Lille Nord de France and Lille University Hospital, Lille, France
  2. 2EA4559, University of Lille Nord de France and Lille University Hospital, Lille, France
  3. 3EA 4488, Department of Rehabilitation Medicine, University of Lille Nord de France and Lille University Hospital, Lille, France
  4. 4Department of Biostatistics, University of Lille Nord de France and Lille University Hospital, Lille, France
  5. 5Department of Nuclear Medicine, University of Lille Nord de France and Lille University Hospital, Lille, France
  6. 6Department of Molecular Biology, INSERM U837/1 JPARC, University of Lille Nord de France and Lille University Hospital, Lille, France
  7. 7Department of Biology and Toxicology, University of Lille Nord de France and Lille University Hospital, Lille, France
  8. 8INSERM U837/6 JPARC, University of Lille Nord de France and Lille University Hospital, Lille, France
  9. 9Department of Medical Pharmacology, University of Lille Nord de France and Lille University Hospital, Lille, France
  10. 10Department of Pharmacology, EA 1046, University of Lille Nord de France and Lille University Hospital, Lille, France
  1. Correspondence to Dr David Devos, Département de Pharmacologie Médicale, Université Lille Nord de France, CHRU de Lille, Lille F-59037, France; david.devos{at}chru-lille.fr
  • Received 9 May 2012
  • Revised 28 August 2012
  • Accepted 3 September 2012
  • Published Online First 16 October 2012

Abstract

Background Given that memantine is thought to decrease N-methyl-D-aspartic-acid-related (NMDA) glutamatergic hyperactivity and improve locomotion in rats, we sought to assess the drug's impact on axial symptoms in advanced Parkinson's disease (PD).

Methods We performed a 90-day, randomised, double-blind, study with two parallel arms: 20 mg/day memantine versus placebo (ClinicalTrials.gov:NCT01108029). The main inclusion criterion was the presence of a severe gait disorder and an abnormal, forward-leaning stance. The following parameters were analysed under standardised conditions before and after acute administration of L-dopa: gait (stride length as primary criterion), the United-Parkinson's-Disease-Rating-Scale (UPDRS) motor score and its axial subscore, the hypertonia and strength of the axial extensors and flexors (isokinetic dynamometer), the Dyskinesia Rating Scale score (DRS) and its axial subscore.

Results Twenty-five patients were included. The memantine and placebo group did not differ significantly in terms of stride length. However, in the memantine group, we observed significantly better results (vs placebo) for the overall UPDRS score (F(1,21)=4.9; p=0.039(−1)) and its axial subscore (F(1,21)=7.2; p=0.014(−1.1)), axial hypertonia, the axial and overall DRS and axial strength.

Conclusions Memantine treatment was associated with lower axial motor symptom and dyskinesia scores but did not improve gait. These benefits must be confirmed in a broader population of patients.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

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