Actigraphic study of tremor before and after treatment with zonisamide in patients with Parkinson's disease

Abstract

In Parkinson's disease (PD), resting tremor, postural tremor, or both often occur as initial symptoms. Levodopa and anticholinergic drugs have been used to manage tremor in PD. However, zonisamide (ZNS) an anticonvulsant, was reported to have beneficial effects especially for “wearing-off” symptoms in patients with PD [ [1] Murata M. Horiuchi E. Kanazawa I. Zonisamide has beneficial effects on Parkinson’s disease patients. Neurosci Res. 2001; 41: 397-399 Crossref PubMed Scopus (122) Google Scholar ]. Miwa et al. [ 2 Miwa H. Hama K. Kajimoto Y. Kondo T. Effects of zonisamide on experimental tremors in rats. Parkinsonism Relat Disord. 2008; 14: 32-36 Abstract Full Text Full Text PDF Scopus (35) Google Scholar , 3 Miwa H. Koh J. Kajimoto Y. Kondo T. Effects of T-type calcium channel blockers on parkinsonian tremor model in rats. Pharmacol Biochem Behav. 2001; 97: 656-659 Crossref Scopus (38) Google Scholar ] reported that ZNS significantly suppressed tremor in an experimental rat model of PD. On the basis of these findings, ZNS has been used since 2009 to manage tremor in Japanese patients with PD. We have previously used actigraphy to quantitatively evaluate tremor in patients with PD and essential tremor [ 4 Mochio S. Oka H. Sato H. Katayama K. Kurita A. Quantitative assessment of motor activity in Parkinson's disease using actigraph. Shinkeinaika. 1996; 45: 351-354 Google Scholar , 5 Mochio S. Oka H. Kurita A. Katayama K. Inoue K. Actigraphic study of motor activity before and after treatment in patients with essential tremor. Shinkeinaika. 2001; 54: 551-556 Google Scholar ]. An actigraph is a motion-sensing apparatus that can detect three-dimensional motor counts of 0.01 G or more. In this study, we quantitatively evaluated tremor by actigraphy before and after treatment with ZNS in PD patients in order to objectively assess whether ZNS is useful for the management of tremor in PD.