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Effects of monotherapy with a monoamine oxidase B inhibitor on motor symptoms in Parkinson’s disease are dependent on frontal function

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Abstract

Background

Monotherapy with monoamine oxidase B (MAO-B) inhibitors enhances the level of endogenous dopamine in treatment for Parkinson’s disease (PD) and provides some benefits. Certain neuropsychiatric functions are also regulated by central dopaminergic activity.

Aim

To investigate the relationship of the efficacy of monotherapy with MAO-B inhibitors on motor symptoms in PD with baseline cognitive function.

Patients and methods

Outcomes were examined for 27 consecutive drug-naïve PD patients who received initial treatment with a MAO-B inhibitor (selegiline: 11, rasagiline: 16). Selegiline was titrated to an optimal dose. The dose of rasagiline was fixed at 1 mg/day. Motor symptoms were assessed using the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III before treatment and after the efficacy reached a plateau within 19 weeks after drug initiation, and the % improvement in motor symptoms was calculated. Pre-treatment cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). Correlations of % improvement in motor symptoms and baseline cognitive assessments were examined using Spearman correlation coefficients and multiple regression analysis.

Results

In all patients, the mean % improvement in motor symptoms was 46.5% (range 0–83.3%). Spearman correlation coefficients showed the % improvement in motor symptoms was correlated with FAB (r = 0.631, p < 0.001). In multiple regression analysis with patient background factors as independent variables, only FAB was associated with improvement in motor symptoms in the MAO-B group.

Conclusion

Better FAB scores predict a significant improvement in motor symptoms with treatment with MAO-B inhibitors, suggesting high activity of endogenous dopamine.

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Funding

This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) (21K03075), and by the Jikei University Research Fund.

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Authors and Affiliations

  1. Department of Neurology, School of Medicine, The Jikei University, 3-25-8 Nishi-Shimbashi Minato-Ku 105-8461, Tokyo, Japan

    Hidetomo Murakami, Motohiro Okumura, Masakazu Ozawa, Masahiro Mimori, Takahiro Maku, Tomotaka Shiraishi, Tomomichi Kitagawa, Hiroki Takatsu, Takeo Sato, Teppei Komatsu, Kenichiro Sakai, Tadashi Umehara, Hidetaka Mitsumura & Yasuyuki Iguchi

  2. Department of Neurology, The Jikei University Katsushika Medical Center, 6-42-1 Aoto Katsushika-Ku 125-8506, Tokyo, Japan

    Shusaku Omoto

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  1. Hidetomo Murakami
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Corresponding author

Correspondence to Hidetomo Murakami.

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Ethical approval and consent to participate

The study was approved by the Ethics Committee of The Jikei University School of Medicine (27-315 (8200)), and was performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants.

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The authors declare no competing interests.

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Murakami, H., Okumura, M., Ozawa, M. et al. Effects of monotherapy with a monoamine oxidase B inhibitor on motor symptoms in Parkinson’s disease are dependent on frontal function. Neurol Sci 44, 913–918 (2023). https://doi.org/10.1007/s10072-022-06499-6

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