{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:03:03Z","timestamp":1767895383106,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2021,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>We aimed to evaluate the effect of zonisamide (ZNS) on motor symptoms and nonmotor symptoms such as depressive symptoms and sleep problems in Parkinson\u2019s disease (PD) patients with or without tremor.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a 3\u2010month, open\u2010label study to assess the effects of ZNS on motor symptoms, depressive symptoms and sleep problems. Twenty levodopa\u2010treated PD patients with motor fluctuation completed the study. Patients received 25\u201350\u00a0mg\/day of ZNS and were assessed for the Japanese version of the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS\u2010UPDRS) parts I, III, and IV, PD Sleep Scale (PDSS)\u20102, Beck depression inventory\u20102 (BDI\u2010II), and PD Questionnaire (PDQ\u20108) at baseline and after 1, 2 and 3\u00a0months of treatment. Patients were categorized into the tremor group and nontremor group to assess changes in clinical parameters.<\/jats:p><\/jats:sec>Results<\/jats:title>At 3\u00a0months, the scores on the MDS\u2010UPDRS parts I, III and IV significantly improved and off\u2010time reduced compared to baseline. Additionally, the PDSS\u20102 total score significantly decreased at 3\u00a0months. Although there were no significant differences in changes in UPDRS part I, III, or IV between the groups after ZNS treatment, the tremor group had significant improvements in PDSS\u20102 at 3\u00a0months and BDI\u2010II at 1, 2 and 3\u00a0months compared with the nontremor group.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We showed the beneficial effects of ZNS on motor symptoms and sleep problems in levodopa\u2010treated PD patients with motor fluctuation. ZNS may be more effective for several nonmotor symptoms in PD patients with tremor compared with those without tremor.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.2026","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T04:46:09Z","timestamp":1609908369000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Zonisamide effects on sleep problems and depressive symptoms in Parkinson\u2019s disease"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-8993","authenticated-orcid":false,"given":"Keisuke","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Neurology Dokkyo Medical University Mibu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-7916","authenticated-orcid":false,"given":"Hiroaki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of 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