{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:22:31Z","timestamp":1780626151710,"version":"3.54.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2023,8,29]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In patients with dementia with Lewy bodies (DLB), it is unknown whether adjunct zonisamide is as effective and safe as increasing levodopa dose when levodopa has inadequate efficacy on parkinsonism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare adjunct zonisamide 25\u200amg\/day versus an increased levodopa dose (increased by 100\u200amg\/day) in patients with DLB treated with levodopa \u2264300\u200amg\/day for parkinsonism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The DUEL study was a multicenter, randomized, controlled, open-label, parallel-group, interventional, non-inferiority trial. During the observation period, levodopa was administered at \u2264300\u200amg\/day for 4 weeks. Subsequently, patients were randomized to receive adjunct zonisamide 25\u200amg\/day or levodopa increased by 100\u200amg\/day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Respective adjusted mean changes in MDS-UPDRS Part III total score at 16 and 24 weeks (primary endpoint) were \u20136.3 and \u20134.4 in the zonisamide add-on and \u20130.8 and 2.0 in the levodopa increase groups. The adjusted mean difference at 24 weeks was \u20136.4 (95% confidence interval [CI] \u201313.5, 0.7); the upper limit of the 95% CI (0.7) was lower than the non-inferiority margin (3.0). No significant between-group differences were observed in total scores of the MDS-UPDRS Part II, Eating Questionnaire, EuroQol-5 dimension-5 level, Zarit Caregiver Burden Interview, or other secondary endpoints. No notable between-group differences were observed in adverse event incidences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Adjunct zonisamide 25\u200amg\/day may yield moderate improvement in motor symptoms in patients with DLB when the levodopa effect is insufficient, but it could not be verified that the zonisamide 25\u200amg\/day was as effective as levodopa 100\u200amg\/day because levodopa showed no sufficient efficacy as assumed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/jad-230335","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T11:20:59Z","timestamp":1689938459000},"page":"251-264","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of Adjunctive Therapy with Zonisamide Versus Increased Dose of Levodopa for Motor Symptoms in Patients with Dementia with Lewy Bodies: The Randomized, Controlled, Non-Inferiority DUEL Study"],"prefix":"10.1177","volume":"95","author":[{"given":"Manabu","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuro","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Orimo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kamiyoga Setagaya Street Clinic, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Medical Innovation, Osaka University Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Konishi","sequence":"additional","affiliation":[{"name":"Medical Science, Sumitomo Pharma Co., Ltd., Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00619-7"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afi190"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004058"},{"key":"ref004","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2017.01.004"},{"key":"ref005","first-page":"435","volume":"22","author":"Gomperts SN","year":"2016","journal-title":"Continuum (Minneap Minn)"},{"key":"ref006","doi-asserted-by":"publisher","DOI":"10.1111\/jnc.14698"},{"key":"ref007","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-018-00636-7"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-022-01130-4"},{"key":"ref009","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12399"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12408"},{"key":"ref011","unstructured":"Dementia Clinical Practice Guideline Development Committee, Japanese Society of Neurology. 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