Singer M, Romero B, Koenig E, Förstl H, Brunner H
Alzheimer Therapiezentrum der Neurologischen Klinik, Bad Aibling, Deutschland.
Nervenarzt. 2005 Sep;76(9):1127-8, 1129. doi: 10.1007/s00115-004-1856-7.
Dementia of the Alzheimer type (DAT) has been linked to losses of cholinergic function in the brain. The acetylcholinesterase inhibitors donepezil, rivastigmine and galantamine improve cognitive performance in manifest dementia. These substances, however, also influence the quality of sleep, and particularly the quality and amount of dreams. We therefore investigated the influence of the time point of donepezil intake on the occurrence of nightmares. We observed a clear-cut relationship between the occurrence of nightmares and an evening dose of donepezil in eight patients with DAT. None of these patients reported nightmares when donepezil was taken in the morning. We suggest that the activation of the visual association cortex during REM sleep is enhanced by donepezil, a mechanism most likely facilitating the development of nightmares in patients with DAT.
阿尔茨海默型痴呆（DAT）与大脑胆碱能功能丧失有关。乙酰胆碱酯酶抑制剂多奈哌齐、卡巴拉汀和加兰他敏可改善明显痴呆患者的认知表现。然而，这些物质也会影响睡眠质量，尤其是梦境的质量和数量。因此，我们研究了多奈哌齐服药时间点对噩梦发生的影响。我们观察到8例DAT患者的噩梦发生与晚上服用多奈哌齐之间存在明确的关系。当多奈哌齐在早晨服用时，这些患者均未报告有噩梦。我们认为，多奈哌齐可增强快速眼动睡眠期间视觉联合皮层的激活，这一机制很可能促进了DAT患者噩梦的发生。
