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
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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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.