alexa Are Cholinesterase Inhibitors Effective in Improving Balance in Parkinsons Disease?
ISSN: 2329-6895

Journal of Neurological Disorders
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Are Cholinesterase Inhibitors Effective in Improving Balance in Parkinsons Disease?

Hiller ALP1,2, Nutt JG1, Mancini M1*, Horak FB1,2, Kareus S1,2,3, Schoneburg BM1,2,4 and Chung KA1,2
1Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
2Department of Neurology, VA Portland Health Care System, Portland, Oregon, USA
3Department of Neurology, Grand Junction, Colorado, USA
4Department of Neurology, Glenview, Illinois, USA
Corresponding Author : Martina Mancini
Department of Neurology
OHSU, Mail Code OP32
3181 SW Sam Jackson Park Road
P.O. Box: 97239, Portland, USA
Tel: 5033460842
Fax: 5034949059
E-mail: [email protected]
Received September 08, 2015; Accepted September 08, 2015; Published September 12, 2015
Citation:Hiller ALP, Nutt JG, Mancini M, Horak FB, Kareus S, et al. (2015) Are Cholinesterase Inhibitors Effective in Improving Balance in Parkinson’s Disease? J Neurol Disord S2:002. doi:10.4172/2329-6895.S2-002
Copyright: ©2015 Hiller ALP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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Abstract

Background:Cholinesterase inhibitors have been reported to reduce falls in a double blind pilot study. The mechanism by which cholinesterase inhibitors reduce falls is unknown. Methods: A pilot, double-blind, placebo-controlled, crossover study examined the effects of donepezil on posturography and frontal executive function. Participants received 6 weeks of treatment with placebo and donepezil in random order, separated by a month washout. Inclusion criteria were an MMSE > 27 and balance impairment on clinical and sensory orientation posturography (SOT) assessments.

Results: Ten participants completed the study. Donepezil improved postural sway in SOT condition 4 (C4, eyes open, sway referenced surface) (p<0.03). The change seen in executive performance (measured by the Trail B-A time) when on donepezil correlated with improvement in SOT C4, r=0.80, p=0.001.

Conclusion: Cholinesterase inhibitors improved two functions related to fall risk, standing balance on an unstable surface and executive set-switching in subjects with PD. We hypothesized that the cholinesterase inhibitor, donepezil, affects fall risk by improving sensory orientation set-switching for balance related to improvements in executive setswitching.

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