Department of Neurology, Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur 3877, Col. La Fama, Tlalpan, 14269 Mexico, DF, Mexico.
Neurol Sci. 2013 Jun;34(6):979-83. doi: 10.1007/s10072-012-1180-0. Epub 2012 Sep 7.
The objective of this study is to assess the effect of smoking and caffeine intake in the dosage of dopaminergic replacement therapy. Patients were recruited from the movement disorders clinic of the National Institute of Neurology and Neurosurgery in Mexico City. An interviewer-administered structured questionnaire was given to all subjects regarding their smoking and caffeine drinking habits. Dopaminergic replacement therapy information was collected and levodopa, dopamine agonists, and levodopa equivalent daily doses were calculated. 146 Parkinson's disease patients (50 % female) were included. All patients were on antiparkinsonian treatment, with a mean levodopa equivalent daily dose (LEDD) of 550.2 ± 408. Patients were stratified according to smoking and caffeine drinking status. 104 (71.2 %) of the patients were "never smokers", 33 (22.6 %) were "former smokers" and 9 (6.2 %) were "current smokers". 40 (27.4 %) patients reported no history of caffeine intake, 36 (24.7 %) were former consumers and 70 (47.9 %) were current caffeine drinkers. No association between LEDD and smoking or caffeine intake was found. A weak positive correlation (r = 0.22, p < 0.04) was found between the daily dose of pramipexole and the daily intake of caffeine. LEDD, levodopa daily dose and dopamine agonist daily dose were not related to smoking or caffeine intake status. We found a weak correlation between caffeine daily intake and pramipexole dose. Further prospective exploration is needed to address the interaction of concomitant A2A antagonism induced by caffeine intake and dopaminergic replacement therapy.
本研究旨在评估吸烟和咖啡因摄入剂量对多巴胺替代疗法的影响。研究对象均来自墨西哥城国家神经病学与神经外科学研究所的运动障碍门诊。所有受试者均通过访谈者管理的结构化问卷，报告其吸烟和咖啡因摄入习惯。收集了多巴胺替代疗法信息，并计算了左旋多巴、多巴胺激动剂和左旋多巴等效日剂量。共纳入 146 例帕金森病患者（50%为女性）。所有患者均接受抗帕金森病治疗，左旋多巴等效日剂量（LEDD）平均为 550.2±408。根据吸烟和咖啡因摄入状况对患者进行分层。104 例（71.2%）患者为“从不吸烟者”，33 例（22.6%）为“曾经吸烟者”，9 例（6.2%）为“当前吸烟者”。40 例（27.4%）患者报告无咖啡因摄入史，36 例（24.7%）为曾经消费者，70 例（47.9%）为当前咖啡因饮用者。未发现 LEDD 与吸烟或咖啡因摄入之间存在相关性。发现普拉克索的每日剂量与咖啡因的每日摄入量之间存在弱正相关（r=0.22，p<0.04）。LEDD、左旋多巴每日剂量和多巴胺激动剂每日剂量与吸烟或咖啡因摄入状态无关。我们发现咖啡因每日摄入量与普拉克索剂量之间存在弱相关性。需要进一步进行前瞻性探索，以解决咖啡因摄入引起的 A2A 拮抗作用与多巴胺替代疗法之间的相互作用。
