Dalfampridine and Gait in Spinocerebellar Ataxias

Not Applicable

Completed

Conditions: Spinocerebellar Ataxias Type 1
Spinocerebellar Ataxias Type 3
Spinocerebellar Ataxias Type 2
Spinocerebellar Ataxias Type 6

Brief Summary: Investigators expect there will be improvement in walking speed and steadiness after taking Dalfampridine, thereby improving activities of daily living and enhancing social and occupational functions for patients with spinocerebellar ataxia.

Detailed Description: Twenty spinocerebellar ataxia patients will be randomized to receive either Dalfampridine or placebo over a total period of 10 weeks. After entering the study, patients will return every 2 weeks for evaluation. After four weeks, intervention will be stopped and patient will enter a 2-week wash out period where they do not take any drug. Then, patients will be given the opposite treatment (Dalfampridine or placebo) and this "crossover" study will be performed for another 4 weeks. Investigators expect there will be improvement in walking speed and steadiness after taking Dalfampridine, thereby improving activities of daily living and enhancing social and occupational functions.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Patients who has severe ataxia and unable to ambulate.
Any orthopedic condition that would affect motor performance.
Patients with secondary ataxia from general medical disorders
Individuals who have major psychiatric disorders that prevents compliance
History of epilepsy
Patients with active drug or alcohol use or dependence that would interfere with adherence to study requirements
Inability or unwillingness of subject or legal guardian/representative to give written informed consent.

Arm && Interventions

Group	Intervention	Description
Placebo, Then Dalfampridine	Placebo	Participant first receive Placebo tablet orally every 12 hours, for a 4 weeks period. After a washout period of 2 weeks, they then receive Dalfampridine at an oral dose of 10mg every 12 hours, for 4 weeks.
Dalfampridine and then placebo	Placebo	Participant first receive Dalfampridine at an oral dose of 10mg every 12 hours, for 4 weeks. After a washout period of 2 weeks, they then receive Placebo tablet orally every 12 hours, for a 4 weeks period.
Dalfampridine and then placebo	Dalfampridine	Participant first receive Dalfampridine at an oral dose of 10mg every 12 hours, for 4 weeks. After a washout period of 2 weeks, they then receive Placebo tablet orally every 12 hours, for a 4 weeks period.
Placebo, Then Dalfampridine	Dalfampridine	Participant first receive Placebo tablet orally every 12 hours, for a 4 weeks period. After a washout period of 2 weeks, they then receive Dalfampridine at an oral dose of 10mg every 12 hours, for 4 weeks.

Primary Outcome Measures

Name	Time	Method
Change in Timed 25 Feet Walking Test (T25FW)	Baseline and 4 weeks after Dalfampridine or placebo	The patient is directed to one end of a clearly marked 25-foot course and is instructed to walk 25 feet as quickly as possible, but safely. The time, in seconds, is calculated from the initiation of the instruction to start and ends when the patient has reached the 25-foot mark. Baseline values are recorded twice. One was at the beginning of the intervention. The second was 2 weeks after washout period and before the second intervention.

Secondary Outcome Measures

Name	Time	Method
Biomechanical Assessment of Gait (BAG)-Stride Length	Baseline and 4 weeks after Dalfampridine or placebo	Biomechanical Assessment of Gait is a sensitive, quantitative movement analysis system. Stride length was analyzed. Baseline values are recorded twice. One was at the beginning of the intervention. The second was 2 weeks after washout period and before the second intervention.
Change in Scale of Assessment and Rating of Ataxia (SARA)	Baseline and 4 weeks after Dalfampridine or placebo	Scale for the assessment and rating of ataxia (SARA) is a clinical scale that is based on a semiquantitative assessment of cerebellar ataxia on an impairment level. SARA has 8 items that are related to gait, stance, sitting, speech, finger-chase test, nose-finger test, fast alternating movements and heel-shin test. SARA score ranges from 0 to 40, with higher scores indicating more severe disease.