title: Methylphenidate fails to improve gait and muscle tone in patients with sporadic and hereditary spastic paraplegia.
abstract: Based on its action on multiple neurotransmitters, including dopamine, methylphenidate (MPH) is of growing interest as a possible treatment option for several movement disorders. Of special interest are diseases that share gait disturbance and cognitive decline. Based on a single case observation in a patient with hereditary spastic spinal paraplegia (HSP) in which gait was improved with MPH, we performed an open-label study with a longitudinal follow-up in 22 patients with HSP and its sporadic form (SSP). The patients were treated for 6 months with 60 mg of MPH per day. Computerized gait analysis and different scores were performed at baseline, after 6 weeks, and after 6 months of treatment. Although at 6 weeks, the gait velocity was somewhat improved, the drug failed to show any effect on other gait parameters and had no beneficial effect at all after 6 months. Although MPH is of interest for several movement disorders, our study did not show a beneficial effect.
authors.affiliation: Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Klebe
authors.forename: Günther
authors.initials: G
authors.lastname: Deuschl
authors.forename: Henning
authors.initials: H
authors.lastname: Stolze
mesh_terms: D000251:Adenosine Triphosphatases / Q000235:genetics; D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002889:Chromosomes, Human, Pair 2; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000187:drug effects*; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009129:Muscle Tonus / Q000187:drug effects*; D010264:Paraplegia / Q000188:drug therapy*; D012815:Signal Processing, Computer-Assisted; D015419:Spastic Paraplegia, Hereditary / Q000188:drug therapy*; D000074181:Spastin; D017211:Treatment Failure
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000251:Adenosine Triphosphatases; D000074181:Spastin; C400283:SPAST protein, human