{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:28:21Z","timestamp":1760956101300,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cervical dystonia (CD) is the most common focal isolated dystonia. Preclinical studies report that AMPA\u2010selective glutamate receptor antagonists improve dystonia. Perampanel is a clinically available, AMPA receptor antagonist that has shown efficacy and safety in epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine safety and tolerability of perampanel in CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a phase 2a, open\u2010label, multicenter study to evaluate tolerability and safety of perampanel in CD. Included subjects had primary CD; those on botulinum toxin were 8\u2009weeks post last injection. All subjects received perampanel 2\u2009mg\/day, titrated 2\u2009mg weekly over 6\u2009weeks, to maximum 12\u2009mg\/day; maintenance phase was 4\u2009weeks, ending at week 10. Primary endpoints included tolerability, defined as ability to remain on perampanel for the maintenance period, at any dose level and safety, determined from adverse events (AEs) collected at each visit. Secondary exploratory endpoints included Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), quality of life (cervical dystonia impact profile [CIDP]\u201058) and Clinical Global Impression of change (CGI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CD participants (n\u00a0=\u00a025) were recruited. Eight subjects withdrew; 4 because of AEs, 3 for other reasons and 1 lost to follow up. One subject tolerated 12\u2009mg\/day. Eight subjects (30.8%) tolerated 2\u2009mg, whereas 19.2% tolerated 4\u2009mg\/day, and 15.4% tolerated 6\u2009mg or 8\u2009mg\/day. All subjects experienced AEs. The most common AEs were dizziness, imbalance, and irritability. Exploratory endpoints of TWSTRS showed some improved pain scores and CIDP\u201058 improved sleep.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tolerability to perampanel was variable in CD subjects. Lower doses would be considered for future studies in this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13229","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T01:38:32Z","timestamp":1619573912000},"page":"743-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An Open\u2010Label Phase 2a Study to Evaluate the Safety and Tolerability of Perampanel in Cervical Dystonia"],"prefix":"10.1002","volume":"8","author":[{"given":"Susan H.","family":"Fox","sequence":"first","affiliation":[{"name":"The Edmond J Safra Program in Parkinson Disease, Toronto Western Hospital  Toronto Ontario Canada"},{"name":"Krembil Brain Institute, University Health Network  Toronto Ontario Canada"},{"name":"Division of Neurology University of Toronto  Toronto Ontario 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