BACKGROUND Rivastigmine is an acetylcholine esterase inhibitor which is commonly used as therapy for dementia in Alzheimer's disease and Parkinson's disease (PD). Recently, a randomized controlled trial demonstrated a positive effect of rivastigmine on gait function in nondemented PD patients. Disturbed gait is a shared hallmark of PD and ataxias. OBJECTIVES We hypothesized that the effect of rivastigmine could be translated to spinocerebellar ataxia (SCA) improving gait function. METHOD Five patients with SCA type 3 were treated with transdermal rivastigmine for 8 weeks. The patients were monitored using the Scale for the Assessment and Rating of Ataxia (SARA) and an electronic walkway system (GAITRite®). RESULTS Gait function was not changed by treatment, but 4 patients who continued treatment for 8 weeks showed improved coordination of extremities. The SARA sum score, which was 7.6 ± 2.2 at baseline, had dropped by 1.5 ± 1.9 after 4 weeks and by 2.1 ± 1.4 after 8 weeks. CONCLUSIONS Contrary to our hypothesis, we observed no improvement of gait parameters as assessed by SARA and GAIT-Rite®, but coordination abilities were improved. Rivastigmine was well tolerated, but known side effects of rivastigmine, such as deterioration of asthma, may appear. Further trials in larger cohorts are needed to confirm our findings.

中文翻译：

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卡巴拉汀对脊髓小脑性共济失调3型患者的影响：5例病例系列

背景卡巴拉汀是一种乙酰胆碱酯酶抑制剂，通常用于治疗阿尔茨海默病和帕金森病（PD）中的痴呆症。最近，一项随机对照试验证明了利凡斯的明对非痴呆 PD 患者步态功能的积极影响。步态紊乱是 PD 和共济失调的共同特征。目标 我们假设利凡斯的明的作用可以转化为脊髓小脑性共济失调 (SCA) 改善步态功能。方法 5 名 SCA 3 型患者接受卡巴拉汀透皮治疗 8 周。使用共济失调评估和评定量表 (SARA) 和电子走道系统 (GAITRite®) 对患者进行监测。结果 步态功能未因治疗而改变，但持续治疗 8 周的 4 名患者的四肢协调能力有所改善。SARA 总分在基线时为 7.6 ± 2.2，在 4 周后下降了 1.5 ± 1.9，在 8 周后下降了 2.1 ± 1.4。结论 与我们的假设相反，我们观察到 SARA 和 GAIT-Rite® 评估的步态参数没有改善，但协调能力得到了改善。利凡斯的明耐受性良好，但可能会出现利凡斯的明已知的副作用，例如哮喘恶化。需要在更大的队列中进行进一步的试验来证实我们的发现。但协调能力得到了提高。利凡斯的明耐受性良好，但可能会出现利凡斯的明已知的副作用，例如哮喘恶化。需要在更大的队列中进行进一步的试验来证实我们的发现。但协调能力得到了提高。利凡斯的明耐受性良好，但可能会出现利凡斯的明已知的副作用，例如哮喘恶化。需要在更大的队列中进行进一步的试验来证实我们的发现。