Dalfampridine in Parkinson's disease related gait dysfunction: A randomized double blind trial

Background Disease-related gait dysfunction causes extensive disability for persons with Parkinson's disease (PD), with no effective therapies currently available. The potassium channel blocker dalfampridine has been used in multiple neurological conditions and improves walking in persons with multiple sclerosis. Objectives We aimed to evaluate the effect of dalfampridine extended release (D-ER) 10 mg tablets twice daily on different domains of walking in participants with PD. Methods Twenty-two participants with PD and gait dysfunction were randomized to receive D-ER 10 mg twice daily or placebo for 4 weeks in a crossover design with a 2-week washout period. The primary outcomes were change in the gait velocity and stride length. Results At 4 weeks, gait velocity was not significantly different between D-ER (0.89 m/s ± 0.33) and placebo (0.93 m/s ± 0.27) conditions. The stride length was also similar between conditions: 0.96 m ± 0.38 for D-ER versus 1.06 m ± 0.33 for placebo. D-ER was generally well tolerated with the most frequent side effects being dizziness, nausea and balance problems. Conclusions D-ER is well tolerated in PD patients, however it did not show significant benefit for gait impairment.