Amantadine hydrochloride treatment in heredodegenerative ataxias: A double blind study
Amantadine hydrochloride treatment in heredodegenerative ataxias: A double blind study
复制标题
DOI：
10.1136/jnnp.61.3.259
复制
发表时间：
1996-09-01
影响因子：
11
通讯作者：
Lalonde, R
中科院分区：
文献类型：
--
作者：
Botez, MI;BotezMarquard, T;Lalonde, R
目的：将27例弗里德赖希共济失调患者和30例侧脑室小脑萎缩患者随机分为两组，一组接受安慰剂治疗，另一组接受盐酸金刚烷胺（AH, 200mg / d）治疗，疗程3 - 4个月。方法：采用简单的左右手视觉听觉反应时间（RT）和运动时间（MT）评价双盲治疗的效果。结果：经协方差分析，接受AH治疗的橄榄桥脑小脑萎缩亚组在8个变量中有7个显著改善。在弗里德里希共济失调患者中，改善明显更少。对于那些有心肌病或药物不耐受的患者，治疗仍然是禁忌。结论：乙酰胆碱在退行性共济失调中的作用可以通过其替代作用（多巴胺释放）和n-甲基- d -天冬氨酸（NMDA）直接参与谷氨酸介导的小脑颗粒细胞神经毒性来解释；美金刚是一种AH类似物，是NMDA受体的有效阻断剂。
Objective-A group of 27 patients with Friedreich's ataxia and another group of 30 patients with olivopontocerebellar atrophies were each randomly divided into two subgroups, one receiving placebo and the other amantadine hydrochloride (AH; 200 mg daily) for three to four months.Methods-The effect of double blind treatment was evaluated by simple visual and auditory reaction time (RT) and movement time (MT) for both right and left hands.Results-The subgroup with olivopontocerebellar atrophies receiving AH showed significant improvement on seven out of eight variables studied by analysis of covariance. In patients with Friedreich's ataxia, improvement was definitely less. Treatment remained contraindicated for those with cardiomyopathies or drug intolerance.Conclusion-The rationale of AH use in heredodegenerative ataxias can be explained by its replacement effect (dopamine release) and by direct involvement of N-methyl-D-aspartate (NMDA) in glutamate mediated neurotoxicity in cerebellar granular cells; memantine, an AH analogue, is a potent blocker of NMDA receptors.