Buspirone, a 5-hydroxytryptamine1A agonist, is active in cerebellar ataxia. Results of a double-blind drug placebo study in patients with cerebellar cortical atrophy.
OBJECTIVE
To establish the antiataxic effect of buspirone hydrochloride, a serotonergic 5-hydroxytryptamine1A (5-HT1A) agonist, in a homogenous group of patients characterized by the same well-defined single condition, cerebellar cortical atrophy.


METHODS
University ataxia research center.


METHODS
Double-blind randomized study of buspirone vs placebo during a 4-month period.


METHODS
Nineteen patients met the inclusion criteria; all completed the study. Of these 19 patients, 9 were treated with placebo and 10 were treated with the drug.


METHODS
A semiquantitative scale for kinetic and static ("postural") cerebellar functions; quantitative clinical measurements measuring time in standard tests that evaluated stance, speech, writing, and drawing; and posturographic analysis of the sway path and sway area of the center-of-foot pressure. The primary end point was improvement of the posttherapeutic change of one of the semiquantitative ataxic scores. The secondary end points were modification of the changes of quantitative measures--clinical or posturographic.


RESULTS
In intention-to-treat analysis, a significant improvement of the primary end point, ie, the posttherapeutic change of the ataxic kinetic score, was shown. Among secondary end points, the maximum time of standing with feet together also was significantly improved.


CONCLUSIONS
Buspirone is active in cerebellar ataxia of patients with cerebellar atrophy. These results confirm the data suggested by open-label studies with buspirone. However, the effect is partial and not clinically major. These pharmacological results might be due to serotonergic mechanisms and confirm a possible link between cerebellar ataxia and the metabolism of serotonin.
Trouillas
P
P
Ataxia Research Center, Hôpital Neurologique, Lyon, France.
Xie
J
J
Adeleine
P
P
Michel
D
D
Vighetto
A
A
Honnorat
J
J
Dumas
R
R
Nighoghossian
N
N
Laurent
B
B
D000328:Adult; D001284:Atrophy; D002065:Buspirone / Q000627:therapeutic use*; D002524:Cerebellar Ataxia / Q000188:drug therapy* / Q000209:etiology; D002531:Cerebellum / Q000473:pathology*; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D016896:Treatment Outcome
D017366:Serotonin Receptor Agonists; D002065:Buspirone