The effectiveness of istradefylline for the treatment of gait deficits and sleepiness in patients with Parkinson’s disease

Abstract Purpose Istradefylline is useful in treating the wearing-off state in Parkinson’s disease (PD). We investigated the effectiveness of istradefylline (ISD) in improving arousal, sleep, and gait deficits in patients with PD. Methods We examined 14 patients with PD treated with ISD. We assessed the patients using the Unified Parkinson's Disease Rating Scale, Parkinson's Disease Questionnaire, Timed Up-and-Go test (TUG), Freezing of Gait Questionnaire (FOG-Q), Epworth Sleepiness Scale (ESS), and Parkinson’s Disease Sleep Scale (PDSS) before and 1 month after ISD use. Results ESS scores were significantly lower 1 month after the start of ISD treatment (6.79 ± 6.50) than before the intervention (8.14 ± 6.15, Wilcoxon signed-rank test, p = 0.0033). PDSS scores were not significantly different 1 month after beginning the treatment (112 ± 23 mm) when compared to those before the intervention (110 ± 27 mm, Wilcoxon signed-rank test, p = 0.40). TUG scores were not changed after 1 month of ISD use (14.9 ± 8.3 s) when compared to those before the intervention (21.3 ± 30.0 s, Wilcoxon signed-rank test, p = 0.59). Although these measures were not significantly affected by ISD treatment, some patients remarkably improved after the treatment. FOG-Q scores were significantly lower 1 month after the beginning of treatment (9.79 ± 7.16) than those before the intervention (12.14 ± 5.82, Wilcoxon signed-rank test, p = 0.030). Conclusions ISD may improve daytime sleepiness and FOG in patients with PD.