Aims.Freezing of gait is a disabling symptom in advanced Parkinson's disease. Positive effects have been suggested with MAO-B inhibitors. We report on an open label clinical study on the efficacy of rasagiline as add-on therapy on freezing of gait and quality of life in patients with Parkinson's disease. Methods. Forty two patients with freezing of gait were treated with 1 mg rasagiline daily as an add-on therapy. Patients were assessed at baseline and after 1, 2 and 3 months of treatment. Freezing of gait severity was assessed using the Freezing of Gait Questionnaire, motor impairment by the modified MDS UPDRS part III, and quality of life using the PDQ-39 questionnaire. Results. Patients treated with rasagiline had a statistically significant decrease in FoG-Q score and modified MDS UPDRS score after 1, 2 and 3 months of therapy. A moderately strong (r = 0.686, P = 0.002) correlation between the effects on mobility and freezing of gait was found. We also observed a statistically significant improvement in global QoL and in the subscales mobility, ADL, stigma and bodily discomfort in patients after 3 months of rasagiline therapy. A significant correlation (r = 0.570, P = 0.02) between baseline FoG-Q score and the baseline score for the PDQ Mobility subscale was found. Conclusion. In our study rasagiline as add-on antiparkinsonian therapy significantly improved mobility, freezing of gait and quality of life. The positive effect on freezing of gait appears to be related to improvement of mobility.

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apy. Methods: Observational, non-interventional, prospective, single-center study of 1 year follow-up from ITB implant onward. Results: 20 consecutive patients with ITB indication were recruited; 13 received an ITB implant during the study period; 1 implant was rejected and thus explanted. 12 patients, of whom 10 had spasticity due to spinal-cord injury, 1 to multiple sclerosis and 1 to adrenoleukodistrophy, provided data for the study and 9 completed follow-up. After 12 months of ITB, mean changes from baseline were: -2.6 on the Penn scale (p= 0.011), -1.1 (p= 0.059) and -2.8 (p= 0.011) on the Ashworth upper and lower scale, respectively and +4.4 on the FIM scale (p= 0.075). Mean utility gain, assessed with the HUI3 scale, was 0.054 (p= 0.091) after 1 year. Mean total ITB test and permanent implant cost per patient were € 528 and € 14,225, respectively. Mean quarterly spending on oral antispastics decreased by € 42 at month 12, while consumption of intrathecal baclofen stabilized after 6 months at € 39. At baseline, 4 patients received botulinum injections, while none did at the end of follow-up. Catheter-related adverse events occurred in 2 out of 12 patients, with a total mean cost per event of € 2.387. While waiting to receive ITB, spasticity-related hospitalizations due to urological complications occurred in 2 out of 20 patients, with a mean cost of € 9.044 per event; no such events were observed after ITB implant. ConClusions: Clinical outcomes of patients with N-FDS improved after ITB. Initial therapy costs were considerable, but were partially offset by savings in drugs and spasticity-related events after 1 year follow-up. Results should be interpreted cautiously because of the small number of observations.

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