Neuroprotective effect of zonisamide in early Parkinson disease : a five–year follow up longitudinal study with PET

Abstract

Objective : To elucidate the in vivo evidence of long–term effects of zonisamide on neuroprotection in Parkinson disease (PD), we examined the chronological changes of neuroinflammation (microglial activation), nigrostriatal degeneration, and clinical symptoms after zonisamide treatment in the early stage of PD using PET.

Methods : Sixteen patients with PD underwent [¹¹C]DPA713 (neuroinflammation marker) and [¹¹C]CFT (dopamine transporter density marker) PET scans. PD patients were divided into groups treated with and without zonisamide. All patients were scanned annually for 5 years. Voxel–wise analysis was used to compare the change in [¹¹C]DPA713 BP_ND and [¹¹C]CFT SUVR between the two groups.

Results : In the zonisamide group, the [¹¹C]DPA713 BP_ND changes were smaller in the whole brain, and the [¹¹C]CFT SUVR changes were smaller in the basal ganglia.

Conclusion : Our results suggested that zonisamide might have long–lasting anti–neuroinflammatory effects, exerting a neuroprotective effect in the nigrostriatal region.