UC HEALTH LINE: Parkinson's Treatment Side Effect Often Similar to Disease Itself

CINCINNATI—Uncontrollable movements are one of the most common visible effects of Parkinson’s disease. But sometimes involuntary movements—particularly turning, wiggling or jerking of the neck and upper body—can actually be a side effect of the very medications used to treat Parkinson’s.

This phenomenon, called dyskinesias, may be alleviated by adjusting medication dosage, says UC Parkinson’s expert Alberto Espay, MD.

But decreasing medication, he adds, can impact quality of life for patients living with this chronic condition. And adding a medication with antidyskinetic effects often works only in the short-term or causes intolerable side effects.

So, finding ways to manage dyskinesias is something Espay has set out to do. He is leading a study looking at the effectiveness of treating dyskinesias with Botox injections—like those commonly used to tighten up the skin and remove wrinkles.  

Botox has been approved by the Food and Drug Administration (FDA) for the treatment of blepharospasm (involuntary closing of the eyelids), cervical dystonia (involuntary forced muscle contractions in the neck region), hyperhidrosis (excessive sweating) and strabismus (squinting of the eyes). The use of Botox for the treatment of dyskinesias is considered investigational and is not approved by the FDA.
 

“Because these injections have proven successful in the treatment of other, similar conditions, we hypothesize that they will be effective in alleviating dyskinesias in Parkinson’s patients,” says Espay, assistant professor of neurology at UC and a member of the Neuroscience Institute at UC and University Hospital. “This study is the first of several that will be necessary to validate this idea.”

Espay will follow two groups of patients for four months—one group will receive Botox injections, and the other group will get saline injections. After four months, the groups will be switched. The group previously receiving Botox injections will now receive saline and vice versa. Espay and his team will observe each set of participants for another four months, gathering data over the course of the study through a series of office visits, digital video recording and self-evaluation.

Parkinson’s disease results from the loss of a group of brain cells that produce the natural neurotransmitter dopamine. Without dopamine, brain nerve cells don’t fire properly, causing an inability to control movement.

The most visible signs of the disease—tremors, difficulty with gait and balance, rigidity and stiffness or general slowness when moving—are blamed on this lack of dopamine production in the brain.

This research is supported by Allergan.

For more information about the study, call (513) 558-7019.

The university, in partnership with the Health Alliance of Greater Cincinnati, established the Neuroscience Institute in 1998 as part of an effort to build upon its national reputation for excellence in neuroscience. The institute includes or is developing research centers that focus on the main diseases of the brain and nerves such as stroke, brain tumors, brain trauma, Parkinson's, Alzheimer's, epilepsy, ALS and multiple sclerosis.