Treatment with istradefylline for postural abnormalities in Parkinson's disease.

Introduction. In the current edition, Fujioka and colleagues report on four Japanese patients with Parkinson disease (PD) and severe postural abnormalities treated with istradefylline (adenosine A2A receptor antagonist); further, dopamine agonists were with-drawn. Three patients experienced significant improvements of postural abnormalities. Clinical reflections. Postural abnormalities in PD include camptocormia, antecollis, lateral trunk flexion, and scoliosis. They may be very pronounced and significantly reduce quality of life. The therapy of postural deformities in PD is currently disappointing. Clinical implications. Effective therapeutic strategies for postural deformities in PD are an unmet need. Larger clinical trials investigating novel approaches including istradefylline are warranted.