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Abstract Details

Randomised Controlled Trial Comparing Efficacy of Zonisamide 25 mg given in addition to standard treatment with standard treatment alone in Tremor dominant Parkinson’s Disease- A Pilot study.
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
138
To compare improvement in  tremor at 12 weeks with Zonisamide  given in  a dose of  25 mg  along with other anti parkinsonian drugs as compared to standard treatment alone in tremor dominant Parkinson’s Disease
In PD patients, compared to bradykinesia and rigidity, tremor  responds the least to available pharmacological therapy-  an important issue in Tremor dominant PD patients. Murata et al, 2007- Zonisamide add on - 25 mg, 50mg, 100 mg compared with placebo- showed significant improvement in UPDRS part III with 25 mg and 50 mg .Animal studies -shown  effect of Zonisamide on tremor. There are studies showing improvement of tremor in Essential tremor patients with Zonisamide.
Single Centre Randomized controlled trial. Randomization- Web based. Permuted block randomisation with variable block sizes of 2,4,6, to two groups- Zonisamide 25 mg , and Placebo. Blinded assessment. Primary outcome- change in UPDRS tremor score at 12 weeks. Secondary outcomes- change in total UPDRS, TETRAS scores and tremor analysis.

In the intention to treat analysis - no significant difference in the follow up UPDRS tremor scores(p value- 0.538, Mann Whitney U test). Best case scenario analysis - significant difference in the follow up UPDRS tremor score (p value- 0.001, Mann Whitney U test).

No significant difference in the follow up UPDRS and TETRAS scores in both the groups (p value- 0.28 and 0.57 respectively, Mann Whitney U test), as well as in change from baseline of the scores in both the groups (p value- 0.15 and 0.23 respectively).

 A significant difference noted in the change from baseline bradykinesia scores in both the groups ( p value- 0.003, Mann Whitney U test).

 
Safe adverse effect profile. Preliminary evidence in best case scenario analysis suggesting Zonisamide in a dose of 25 mg OD may have a beneficial effect on tremor in Tremor Dominant PD patients, larger studies required.
Authors/Disclosures
Kanchana S. Pillai, MD (Department of Medicine and Neurology)
PRESENTER 		Dr. Pillai has nothing to disclose.
Vinay Goyal Goyal, MD, DM, FIAN (Director Neurology) Prof. Goyal has nothing to disclose.
Achal K. Srivastava, MD, FÂ鶹´«Ã½Ó³»­ (AIIMS) Dr. Srivastava has nothing to disclose.
Roopa Rajan (Sree Chitra Tirunal Institute for Medical Sciences and Technology) Roopa Rajan has received research support from DBT. Roopa Rajan has received research support from DST-SERB. The institution of Roopa Rajan has received research support from Michael J Fox Foundaton.
Kanchana S. Pillai, MD (Department of Medicine and Neurology) Dr. Pillai has nothing to disclose.
Divya M. Radhakrishnan, MD, DM (Neurology) (All India Institute of Medical Sciences, New Delhi, India) The institution of Dr. Radhakrishnan has received research support from Indian Council of Medical Research, New Delhi, India. Dr. Radhakrishnan has received research support from International Parkinson's and Movement Disorders Society, Asian Oceanian Section . The institution of Dr. Radhakrishnan has received research support from All India Institute of Medical Sciences, New Delhi, India.
Mamta B. Singh, MD, MBBS, DM, FÂ鶹´«Ã½Ó³»­ (All India Institute of Medical Sciences) Dr. Singh has nothing to disclose.
Venugopalan Y. Vishnu, MD (All India Institute of Medical Sciences, New Delhi) The institution of Dr. Vishnu has received research support from Department of Health Research.
Arunmozhimaran Elavarasi, MD (All India Institute of Medical Sciences) Dr. Elavarasi has stock in Pfizer. Dr. Elavarasi has stock in PGHL. The institution of Dr. Elavarasi has received research support from All India Institute of Medical Sciences, New Delhi. The institution of Dr. Elavarasi has received research support from Indian Council for Medical Research.