Safinamide improves executive functions in fluctuating Parkinson’s disease patients: an exploratory study

Rinaldi, Domiziana; Sforza, M; Assogna, Francesca; Savini, Cinzia; Salvetti, Marco; Caltagirone, Carlo; Spalletta, Gianfranco; Pontieri, Francesco E.

doi:10.1007/s00702-020-02259-y

Cited by 19 publications

(15 citation statements)

References 19 publications

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“…Safinamide may potentially modulate the dopamine availability within these pathways [37]. This hypothesis is supported by a recent study, which showed that safinamide add-on may improve executive functions in patients with PD [38]. Interestingly, pre-human studies have suggested that glutamatergic NMDA-mediated neurotransmission may be involved in the pathophysiology of Alzheimer's disease, also modulating the formation of amyloid and tau protein aggregates [39].…”

Section: Discussionmentioning

confidence: 86%

Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson’s disease patients: a prospective longitudinal study

et al. 2021

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Introduction Parkinson’s disease (PD) patients in chronic levodopa treatment may experience motor and non-motor fluctuations, which may affect their quality of life. Safinamide is a new monoamine oxidase B inhibitor, also exerting a non-dopaminergic effect, recently approved as add-on therapy in fluctuating PD patients. Methods We performed a longitudinal prospective study in a cohort of 20 fluctuating PD patients, to test whether safinamide 50 mg may improve non-motor, cognitive, and behavioral symptoms over a 6-month treatment period. At each timepoint, clinical features were assessed by means of validated PD-specific scales. Neuropsychological assessment was performed by exploring all five cognitive domains. Results Compared to baseline, significant improvement was found in PD patients at 6-month follow-up in items investigating interest (p = 0.02), motivation (p = 0.02), and urinary disturbances (p = 0.03). Moreover, neuropsychiatric assessment showed a significant decrease in fatigue and apathy scores (p = 0.02 and p = 0.01, respectively). Motor assessment revealed a significant reduction in the total wake-up time spent in OFF state (p = 0.01). Follow-up neuropsychological evaluation did not reveal any change compared to baseline. Conclusions Our data reveal that, along with motor fluctuation improvement, treatment with safinamide 50 mg may significantly decrease non-motor symptom burden in PD patients. Interestingly, non-dopaminergic mechanisms, such as glutamatergic overdrive, have been demonstrated to play a role in many pathways underlying these symptoms. Thus, we hypothesize that the neurotransmitter receptor-binding profile of safinamide may explain our findings.

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Section: Discussionmentioning

confidence: 86%

Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson’s disease patients: a prospective longitudinal study

et al. 2021

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“…Two single-center open-label prospective studies from the same group investigated the effects of MAO-BIs in PD patients with wearing-off 67 , 68 . The unique point of these studies was that cognitive assessments were performed 20 min before the second scheduled daily dose of levodopa.…”

Section: Resultsmentioning

confidence: 99%

Effects of MAO-B inhibitors on non-motor symptoms and quality of life in Parkinson’s disease: A systematic review

Tsuboi

Satake

Hiraga

et al. 2022

npj Parkinsons Dis.

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Non-motor symptoms (NMS) are common among patients with Parkinson’s disease and reduce patients’ quality of life (QOL). However, there remain considerable unmet needs for NMS management. Three monoamine oxidase B inhibitors (MAO-BIs), selegiline, rasagiline, and safinamide, have become commercially available in many countries. Although an increasing number of studies have reported potential beneficial effects of MAO-BIs on QOL and NMS, there has been no consensus. Thus, the primary objective of this study was to provide an up-to-date systematic review of the QOL and NMS outcomes from the available clinical studies of MAO-BIs. We conducted a literature search using the PubMed, Scopus, and Cochrane Library databases in November 2021. We identified 60 publications relevant to this topic. Overall, rasagiline and safinamide had more published evidence on QOL and NMS changes compared with selegiline. This was likely impacted by selegiline being introduced many years prior to the field embarking on the study of NMS. The impact of MAO-BIs on QOL was inconsistent across studies, and this was unlikely to be clinically meaningful. MAO-BIs may potentially improve depression, sleep disturbances, and pain. In contrast, cognitive and olfactory dysfunctions are likely unresponsive to MAO-BIs. Given the paucity of evidence and controlled, long-term studies, the effects of MAO-BIs on fatigue, autonomic dysfunctions, apathy, and ICD remain unclear. The effects of MAO-BIs on static and fluctuating NMS have never been investigated systematically. More high-quality studies will be needed and should enable clinicians to provide personalized medicine based on a non-motor symptom profile.

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“…The observation that the control sample (SA−), in which treatment modifications were mostly dopaminergic, did not experience any change in their urinary problems, may support this too. A nondopaminergic effect of safinamide on attention, mood and anxiety, suggested by different studies, could be relevant in this regard, helping a better control of micturition from higher order cortical centers [ 29 , 37 , 38 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

SURINPARK: Safinamide for Urinary Symptoms in Parkinson’s Disease

Gómez-López,

Sánchez-Sánchez,

Natera-Villalba

et al. 2021

Brain Sciences

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Background: Urinary symptoms are common, disabling and generally unresponsive to treatment in Parkinson´s disease (PD). Safinamide is approved as an add-on therapy to levodopa to improve fluctuations. Methods: Retrospective analysis of electronic records of nondemented PD patients seen consecutively in a Movement Disorders Unit (November 2018–February 2019). All were assessed with Scale for Outcomes in Parkinson’s disease for Autonomic Symptoms-Urinary subscale (SCOPA-AUT-U) by the attending neurologist, and a month afterwards by an independent researcher blinded to treatment and clinical records in a routine clinical practice setting. Clinical variables were compared among patients who were prescribed safinamide (SA+) for the treatment of motor fluctuations and those with different treatment regimes (SA−). Results: From 169 patients screened initially, 54 were excluded due to severe incontinence, absence of urinary symptoms or previous safinamide treatment. Thirty-five patients were included in SA+ and 79 in SA−. Both groups were comparable in terms of clinical variables, except in basal urinary symptoms, with more severity in the SA+ group. In the follow-up assessment, total SCOPA-AUT-U, as well as urgency, incontinence, frequency and nocturia subscales improved significantly in the SA+ group, while the SA− group remained unchanged. Conclusions: Safinamide could be helpful in the improvement of urinary symptoms in PD.

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Safinamide improves executive functions in fluctuating Parkinson’s disease patients: an exploratory study

Cited by 19 publications

References 19 publications

Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson’s disease patients: a prospective longitudinal study

Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson’s disease patients: a prospective longitudinal study

Effects of MAO-B inhibitors on non-motor symptoms and quality of life in Parkinson’s disease: A systematic review

SURINPARK: Safinamide for Urinary Symptoms in Parkinson’s Disease

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