AbstractAlthough resting tremor is the most identifiable sign of Parkinson's disease, its underlying basis appears to be the most complex of the cardinal signs. The variable relationship of resting tremor to other symptoms of PD has implications for diagnosis, prognosis, medical and surgical treatment. Structural lesions very rarely cause classic resting tremor, with likely contributions to tremor by a network of neurons both within and outside the basal ganglia. Patients with only resting tremor show dopaminergic deficits with radioligand imaging, but severity of tremor correlates poorly in such dopamine imaging studies. Correlation of tremor severity to changes in radioligand studies is also limited by the use of mostly qualitative measures of tremor severity. A complex pharmacologic basis of parkinsonian resting tremor is supported by treatment studies. Although levodopa is clearly effective for resting tremor, several agents have shown efficacy that appears to be superior or additive to that of levodopa including anticholinergics, clozapine, pramipexole, and budipine. Although the thalamus has the greatest body of evidence supporting its role as an effective target for surgical treatment of tremor, recent studies suggest that the subthalamic nucleus may be a reasonable alternative target for patients with Parkinson's disease and severe tremor as the predominant symptom. © 2007 Movement Disorder Society

01 Jan 2007·Handbook of Clinical Neurology

Antiglutamatergic drugs in the treatment of Parkinson's disease

Article

Author: María Graciela Cersósimo ; Federico Eduardo Micheli

Publisher Summary This chapter focuses on antiglutamatergic drugs in the treatment of Parkinson's disease (PD). In the vertebrate brain, glutamate is the main excitatory neurotransmitter and mediates neurotransmission of most excitatory synapses. Glutamate-mediated synaptic transmission is essential for the normal functioning of the central nervous system. The ideal antiglutamatergic drug should largely be able to block the N-methyl-D-aspartate (NMDA) receptor in situations of excessive activation but without altering glutamatergic transmission during normal conditions. Amantadine is the only antiglutamatergic agent used in the management of PD patients and is particularly useful for the treatment of levodopa-induced dykinesias. Amantadine interacts with several different neurotransmitters systems and exhibits dopaminergic and anticholinergic properties along with antagonist activity of NMDA glutamatergic receptors. Amantadine exhibits mild antiparkinsonian effect and is more effective in the control of bradykinesia and rigidity than in tremor. It also exhibits neuroprotective properties in addition to its symptomatic effects. The chapter also describes some other antiglutamatergic drugs, namely memantine, dextromethorphan, budipine, and riluzole.

01 Oct 2006·Journal of the Neurological SciencesQ4 · MEDICINE

Budipine in Parkinson's tremor

Q4 · MEDICINE

Review

Author: Reichmann, Heinz

It is generally accepted that patients with a tremor-dominant type of idiopathic Parkinson's disease progress more slowly than the ones with the rigid-akinetic type. On the other hand successful treatment of Parkinsonian tremor is a challenge. German neurologists use anticholinergics, budipine, beta-blockers, clozapine, dopaminergic substances and for most severe cases deep brain stimulation. Budipine is an enigma because its main mode of action is still unknown, although it is mostly listed under glutamate antagonists. There is however no other anti-Parkinsonian drug available with such a broad spectrum of action as shown for budipine. Budipine has been studied in open and double-blind studies as monotherapy and adjunct therapy. In both instances the drug showed beneficial effects to the patients. It may well be that the non-dopaminergic mode of action of budipine is helpful even for patients who are on stable medication. When 3 years ago reports on budipine-induced prolongation of the QT interval in the ECG emerged larger trials were stopped and nowadays there are strict rules on how to use budipine. Nonetheless, budipine in our hands is a most useful and safe drug to treat tremor and other main symptoms of Parkinson's disease.

100 Deals associated with Budipine Hydrochloride

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KEGG	Wiki	ATC	Drug Bank
D07589	Budipine Hydrochloride	N04BX03	DB13502

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Indication	Country/Location	Organization	Date
Parkinson Disease	DE	Takeda Pharmaceuticals International AG	07 Oct 1997

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