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This randomized double-blinded placebo-controlled crossover study investigated the effect of ZNS on motor and NMS symptoms and QoL in advanced PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PD patients with Hoehn and Yahr stage\u2009\u2265\u20092 (\u201cOn\u201d state) and at least 2 h off time daily were randomized to groups: ZNS 25 mg, ZNS 50 mg and placebo. Groups were assessed at baseline and at the 1- and 3-month follow-ups. The primary endpoint was the change in the total MDS-UPDRS III \u201cOn\u201d, while the secondary endpoint was the change in the total and parts I and IV MDS-UPDRS, Nonmotor Symptoms Scale and Parkinson\u2019s disease questionnaire-39 at the final assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-nine patients were assessed for efficacy at the 1-month follow-up, and 58 patients were assessed at the 3-month follow-up. The primary endpoint showed significant improvement in the ZNS 25 mg group compared to the placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). At the final assessment, the ZNS 25 mg group showed significant improvement of total and part VI MDS-UPDRS, bradykinesia, tremor and functional impact of fluctuations compared to placebo. There was no change in dyskinesia, NMSs, QoL or side effects except for sedation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ZNS has a favourable effect on motor symptoms in patients with wearing off as adjunctive therapy with other dopaminergic drugs, with no exacerbation of dyskinesia and a limited impact on NMSs and QoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Clinicaltrials.gov, NCT04182399, in 24\/11\/2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-024-07396-w","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T04:03:54Z","timestamp":1708401834000},"page":"1725-1734","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Role of zonisamide in advanced Parkinson\u2019s disease: a randomized placebo-controlled study"],"prefix":"10.1007","volume":"45","author":[{"given":"Mohamed","family":"Essam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Abushady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"El-Balkimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Antonini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7012-5907","authenticated-orcid":false,"given":"Ali","family":"Shalash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"issue":"9","key":"7396_CR1","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1001\/jamaneurol.2022.1783","volume":"79","author":"N Schiess","year":"2022","unstructured":"Schiess N, Cataldi R, Okun MS et al (2022) Six action steps to address global disparities in Parkinson disease: a world health organization priority. 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He receives research support from Chiesi Pharmaceuticals, Lundbeck, Bial, Movement Disorders Society, Horizon2020 Grant 825785, Horizon2020 Grant 101016902, Ministry of Education University and Research (MIUR) Grant ARS01_01081 and Cariparo Foundation. Other authors have no financial conflicts of interest to disclose, with no financial support or funding.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Financial Disclosure"}}]}}