Wang Yan, Yang Yuechang, Wu Huijuan, Lan Danmei, Chen Ying, Zhao Zhongxin
Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Sleep Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
J Clin Sleep Med. 2016 Oct 15;12(10):1403-1409. doi: 10.5664/jcsm.6200.
REM sleep behavior disorder (RBD) is a common manifestation of Parkinson disease (PD). In this study, we assessed the effects of rotigotine transdermal patch on RBD features in patients with PD.
In this prospective open-label study, eleven PD patients with untreated RBD were administered rotigotine patches for up to seven months to ameliorate their parkinsonism. The severities of their RBD symptoms before and after rotigotine therapy were evaluated through patient and bed partner interviews, a validated evaluation scale (REM sleep behavior disorder questionnaire-Hong Kong, RBDQ-HK), and blinded assessments based on video-polysomnographic (VPSG) measure.
Rotigotine improved parkinsonism and subjective sleep quality in PD patients with RBD. The RBDQ-HK total score, especially the Factor 2 score, was decreased, which demonstrated that the subjective severity of RBD symptoms was improved after rotigotine treatment, especially the frequency and severity of abnormal RBD-related motor behaviors. The VPSG analyses showed that the total sleep time (TST) and stage 1% were increased and that the PLMS index was decreased. However, no differences in the RBD-related sleep measures were observed.
The improved RBD symptoms and VPSG measures of PD patients in this study (TST, stage 1%, and PLMS index) suggest that, in PD, rotigotine may partially improve RBD-related symptoms. Rotigotine should be considered to be an optional drug for the treatment of RBD symptoms in PD.
快速眼动睡眠行为障碍(RBD)是帕金森病(PD)的常见表现。在本研究中,我们评估了罗替戈汀透皮贴剂对PD患者RBD特征的影响。
在这项前瞻性开放标签研究中,11名未经治疗的RBD的PD患者接受了长达7个月的罗替戈汀贴剂治疗以改善其帕金森症状。通过患者和床伴访谈、经过验证的评估量表(快速眼动睡眠行为障碍问卷 - 香港版,RBDQ - HK)以及基于视频多导睡眠图(VPSG)测量的盲法评估,来评估罗替戈汀治疗前后他们的RBD症状严重程度。
罗替戈汀改善了患有RBD的PD患者的帕金森症状和主观睡眠质量。RBDQ - HK总分,尤其是因子2得分降低,这表明罗替戈汀治疗后RBD症状的主观严重程度有所改善,特别是与RBD相关的异常运动行为的频率和严重程度。VPSG分析显示总睡眠时间(TST)和第1期睡眠百分比增加,而周期性肢体运动指数(PLMS指数)降低。然而,未观察到与RBD相关的睡眠指标存在差异。
本研究中PD患者RBD症状和VPSG指标(TST、第1期睡眠百分比和PLMS指数)的改善表明,在PD中,罗替戈汀可能部分改善与RBD相关的症状。罗替戈汀应被视为治疗PD中RBD症状的一种可选药物。