Noncontact Boxing Improves Movement in Parkinson, Riluzole's Lack of Effect in Spincerebellar Ataxia, Positive Impact of Cannabis in Dystonia


Neurology News Network for the week ending September 25, 2021. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

This week Neurology News Network covered a trio of abstracts from MDS Virtual Congress that included the design of a noncontact boxing exercise program in patients with Parkinson disease, lack of evidence for riluzole in spinocerebellar ataxia, and the effects of medical cannabis in improving dystonia symptoms.

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. Please excuse our appearance this week as a majority of the US workforce, including the NeurologyLive team, moves to working remote as we come together to help reduce the spread of the novel coronavirus. This week’s episode was centered around the recently concluded MDS Virtual Congress.

The design protocol of a trial aimed at identifying if a noncontact boxing exercise program can improve movement and quality of life for individuals with Parkinson disease (PD), has been presented MDS 2021. The trial is dubbed FIGHT-PD. It has received ethics approval, and screening has commenced, with some interim results expected to be available before the end of 2021. According to a release, COVID-19 delayed the start of the study, but it is expected to finish in September 2021. FIGHT-PD is planned to take place over the course of 15 weeks, consisting of 3 workouts per week lasting 30-60 minutes. They are to be conducted in a trio of 4-week blocks separated by an active recovery week. The first block focuses on technique; the second block escalates the physical intensity, and the third block adds cognitive challenges. Feasibility details including recruitment, retention, and adherence rates will also be measured by the group.

A recently conducted multicenter, double-blind, placebo-controlled trial found no evidence that riluzole (Rilutek; Sanofi), an FDA-approved drug for patients with amyotrophic lateral sclerosis, can improve clinical or radiological outcomes in patients with spinocerebellar ataxia type 2. Investigators also concluded however, that quantitative measures were more sensitive to change than clinical outcomes and correlated with cerebellar atrophy. Between January 2018 and June 2019, a total of 45 patients with SCA2 were randomized to treatment with 50-mg riluzole (n = 22) or placebo (n = 23) for a 12-month period. Coarelli and colleagues used proportion of patients with 1-point improvement on Scale for the Assessment and Rating of Ataxia (SARA) score as the primary end point. Between both groups, investigators found no significance difference in proportion of patients with 1-point SARA score improvement, as well as the variation of SARA score at month 12.

Data from a real-life study of medical cannabis (MC) on adults with dystonia were presented at MDS Virtual Congress, with investigators concluding MC treatment seemed to improve dystonia symptoms, as well as related pain. A total of 23 patients with a mean age of 52.7 years were interviewed for the small, retrospective pilot study, including patients with focal dystonia (n = 6), multifocal dystonia (n = 1), segmental dystonia (n = 5), generalized dystonia (n = 9), and hemidystonia. A positive correlation was identified between percentage of product tetrahydrocannabinol (THC) and total THC daily dose and subjective improvement of dystonia, P = 0.034, and P = 0.012, respectively, reflecting that patients intaking a higher level of THC showed significant improvement when compared to those consuming lower doses.

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