Objective: To clarify the effects of zonisamide (ZNS) on the core symptoms of dementia with Lewy bodies (DLB), we performed a post-hoc analysis using data of the double-blind randomized placebo-controlled study with the groups of placebo, ZNS-25mg and ZNS-50mg (Phase 2 study).

Background: In the previous annual congress, we showed that ZNS significantly improved parkinsonism (evaluated by a Unified Parkinson’s disease Rating Scale (UPDRS) Part 3 total score) accompanying DLB without exaggerating psychiatric symptoms such as total scores of Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI), and caregiver burden such as Zarit Burden Interview (ZBI) in the Phase 2 study.

Methods: Focusing on core symptoms of DLB, we analyzed tremor, rigidity, akinesia and postural instability, and hallucination for motor and psychiatric symptoms, and also analyzed attention and calculation (Serial 7’s) for cognitive function, the score of which at baseline showed most remarkable decline of all the MMSE items. The study patients were used who have already had each symptom at baseline. Then we compared the change of score (the difference between the baseline and the last evaluation point) in each symptom among the groups.

Results: The patients enrolled in this study had lower degree of tremor than other symptoms, that is a common feature of DLB. The degree of change was significantly greater in rigidity and akinesia, and was relatively greater in tremor and postural instability in the ZNS 50-mg group than those in the placebo group. No notable differences in attention and calculation (Serial 7’s) and hallucination were found among the groups.

Conclusions: Our data suggest that ZNS would improve four motor symptoms of DLB without affecting cognitive impairment and hallucination. Further studies are needed to clarify the characteristics of ZNS effects on DLB.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-zonisamide-on-dementia-with-lewy-bodies-dlb-a-post-hoc-analysis-of-phase-2-study-for-parkinsonism-in-dlb-patients/