Memantine for axial signs in Parkinson's disease: a randomised, double-blind, placebo-controlled pilot study.
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.
Department of Neurology, University of Lille Nord de France and Lille University Hospital, Lille, France.
Caroline
C
Moreau
Arnaud
A
Delval
Vincent
V
Tiffreau
Luc
L
Defebvre
Kathy
K
Dujardin
Alain
A
Duhamel
Gregory
G
Petyt
Claude
C
Hossein-Foucher
David
D
Blum
Bernard
B
Sablonnière
Susanna
S
Schraen
Delphine
D
Allorge
Alain
A
Destée
Régis
R
Bordet
David
D
Devos
D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004185:Disability Evaluation; D004311:Double-Blind Method; D004409:Dyskinesia, Drug-Induced / Q000517:prevention & control; D005260:Female; D020233:Gait Disorders, Neurologic / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D010865:Pilot Projects; D018401:Sample Size
D000978:Antiparkinson Agents; D007980:Levodopa; D008559:Memantine