Ferreira Joaquim J, Mestre Tiago, Guedes Leonor Correia, Coelho Miguel, Rosa Mário M, Santos Ana T, Barra Márcio, Sampaio Cristina, Rascol Olivier
Clinical Pharmacology Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Clinical Pharmacology Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon , Lisbon , Portugal.
Front Neurol. 2016 Mar 8;7:27. doi: 10.3389/fneur.2016.00027. eCollection 2016.
There is limited information available concerning the treatment of daytime somnolence associated with Parkinson's disease (PD); the most frequently applied therapeutic strategies include decreasing the dose of dopamine agonists or adding potential wake-promoting agents. There is recent data from a placebo-controlled trial concluding on a non-significant trend in favor of caffeine. We aimed to evaluate the efficacy of espresso-coffee in the treatment of daytime somnolence in PD. To evaluate the efficacy of espresso-coffee in the treatment of daytime somnolence in PD, we have conducted multiple single-patient (n-of-1) clinical trials comparing regular espresso coffee to decaffeinated coffee in PD patients presenting moderate to severe daytime somnolence defined as an Epworth Sleepiness Scale score >9. Each single-patient (n-of-1) trial included a sequence of three crossovers (two treatment periods separated by two days of washout). Four patients were included in the studies and three completed the three pairs of treatment periods. In two of the four patients, espresso coffee was considered beneficial. This study concludes that multiple single patient trials are feasible in PD and suggests that espresso-coffee may have a beneficial effect on daytime somnolence in some patients. These results cannot be generalized beyond the patients included in these trials.
关于帕金森病（PD）相关日间嗜睡的治疗，可用信息有限；最常应用的治疗策略包括减少多巴胺激动剂剂量或添加潜在的促醒药物。最近一项安慰剂对照试验的数据得出了有利于咖啡因的非显著趋势。我们旨在评估浓缩咖啡治疗PD日间嗜睡的疗效。为评估浓缩咖啡治疗PD日间嗜睡的疗效，我们进行了多项单病例（n-of-1）临床试验，在表现为埃普沃思嗜睡量表评分>9的中度至重度日间嗜睡的PD患者中，将常规浓缩咖啡与脱咖啡因咖啡进行比较。每项单病例（n-of-1）试验包括三个交叉阶段（两个治疗期，中间间隔两天洗脱期）。四项研究共纳入了四名患者，其中三名完成了三对治疗期。四名患者中有两名认为浓缩咖啡有益。本研究得出结论，多项单病例试验在PD中是可行的，并表明浓缩咖啡可能对部分患者的日间嗜睡有有益作用。这些结果不能推广到这些试验所纳入患者之外的人群。
