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Association between dopaminergic medications and REM sleep behavior disorder in Parkinson's disease: a preliminary cohort study.
Journal of Neurology ( IF 4.8 ) Pub Date : 2020-05-29 , DOI: 10.1007/s00415-020-09956-4
Mario Meloni 1 , Marco Bortolato 2 , Antonino Cannas 3 , Ilaria Laccu 4 , Michela Figorilli 4 , Patrizia Congiu 4 , Giovanni Defazio 3 , Federico Meloni 5 , Monica Puligheddu 3, 4
Affiliation  

Background

Rapid eye movement sleep behavior disorder (RBD) is highly comorbid with Parkinson’s disease (PD). Emerging evidence suggests that dopamine-replacement therapies (DRTs) for PD may modify the course of RBD, yet the nature of the association between DRTs and RBD remains unclear. To begin addressing this issue, we conducted a preliminary retrospective study to document whether DRTs are associated with the occurrence of RBD symptoms in PD patients.

Methods

The study included 250 PD patients who were screened for probable RBD via the RBD Screening Questionnaire (RBDSQ). For each patient, disease severity data were collected, in addition to their therapy and the associated levodopa equivalent daily dose (LEDD). The association between DRTs and RBDSQ scores was analyzed using logistic regression and correlation models.

Results

RBD scores were found to be associated with the LEDD of levodopa alone, but not of dopaminergic agonists (mainly D2/D3 receptor agonists) or their combination with levodopa. This association was not accounted for patient age or Hoehn and Yahr (H&Y) severity scores.

Conclusions

Our study detected a significant association between doses of levodopa and RBD symptoms in PD patients. Future longitudinal studies are needed to establish what causal nexus may link these variables.



中文翻译:

多巴胺能药物和帕金森氏病的REM睡眠行为障碍之间的关联:一项初步的队列研究。

背景

快速眼动睡眠行为障碍(RBD)与帕金森氏病(PD)高度合并。新兴证据表明,PD的多巴胺替代疗法(DRT)可能会改变RBD的病程,但DRT与RBD之间的关联性质尚不清楚。为了解决这个问题,我们进行了一项初步的回顾性研究,以记录DRT是否与PD患者RBD症状的发生有关。

方法

该研究纳入了250名通过RBD筛查问卷(RBDSQ)筛查可能的RBD的PD患者。除了治疗和相关左旋多巴等效每日剂量(LEDD)外,还为每位患者收集了疾病严重程度数据。使用logistic回归和相关模型分析了DRT与RBDSQ得分之间的关​​联。

结果

发现RBD评分仅与左旋多巴的LEDD相关,而与多巴胺能激动剂(主要是D2 / D3受体激动剂)或与左旋多巴的组合无关。该关联未考虑患者年龄或Hoehn和Yahr(H&Y)严重程度得分。

结论

我们的研究发现左旋多巴的剂量与PD患者的RBD症状之间存在显着相关性。需要进一步的纵向研究来确定什么因果联系可以将这些变量联系起来。

更新日期:2020-05-29
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