A randomized trial of amantadine in Huntington disease.
BACKGROUND
Huntington chorea, like levodopa-induced dyskinesias, may be responsive to amantadine hydrochloride treatment.


OBJECTIVE
To measure the effect of amantadine treatment on Huntington chorea and to test a hypothesis that the adventitious movements are associated with reduced central proprioception that can be corrected by amantadine treatment.


METHODS
A randomized placebo-controlled cross-over trial with 2 weeks of treatment.


METHODS
A tertiary referral center.


METHODS
Twenty-four subjects with Huntington disease took amantadine hydrochloride, 100 mg 3 times daily for 2 weeks, and placebo for 2 weeks.


METHODS
Chorea of the face, trunk, and limbs while seated was videotaped at baseline and after each study phase. Segments were viewed in random order by blinded reviewers and scored. Proprioception was determined using arm restraints in which the right and left elbows were set at slightly different angles, and the errors in selecting the more extended elbow over 40 trials were recorded.


RESULTS
The chorea score was not correlated with a proprioception deficit. Neither chorea nor proprioception were significantly affected by amantadine therapy. The chorea score was 9.6 (3.1) points at baseline and 9.7 (3.7) points when the patient was receiving amantadine therapy. The 95% confidence interval for the difference between placebo effect and amantadine effect was -1.43 to 1.0 points. Despite this, 19 subjects felt improved during the amantadine phase compared with 6 subjects improved in the placebo phase (P =.006) and the quality of life was better (P<.001).


CONCLUSIONS
Elbow proprioception was not shown to be related to Huntington chorea. Amantadine hydrochloride treatment at doses of 300 mg/d had no effect, on average, for Huntington chorea, although most patients felt subjectively better during the short course of amantadine treatment.
O'Suilleabhain
Padraig
P
Department of Neurology, University of Texas Southwestern Medical School, Dallas 75390, USA.
Dewey
Richard B
RB
D000547:Amantadine / Q000009:adverse effects / Q000627:therapeutic use*; D002819:Chorea / Q000188:drug therapy* / Q000209:etiology; D018592:Cross-Over Studies; D004550:Elbow / Q000502:physiology; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008606:Mental Processes / Q000187:drug effects; D008875:Middle Aged; D004856:Postural Balance / Q000187:drug effects; D011434:Proprioception / Q000187:drug effects; D011597:Psychomotor Performance / Q000187:drug effects; D011788:Quality of Life
D000547:Amantadine