Moccia Marcello, Erro Roberto, Picillo Marina, Vitale Carmine, Longo Katia, Amboni Marianna, Pellecchia Maria Teresa, Barone Paolo
Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.
Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy.
Parkinsonism Relat Disord. 2016 Nov;32:116-119. doi: 10.1016/j.parkreldis.2016.08.005. Epub 2016 Aug 4.
Higher caffeine consumption has been associated with reduced risk of Parkinson's disease (PD), and with a more benign progression of motor and non-motor symptoms (NMS). The present observational cohort study investigated motor and non-motor correlates of caffeine consumption in de novo PD.
79 newly diagnosed, drug naïve PD patients have been included and followed up for 4 years. The total caffeine use was calculated with the Caffeine Consumption Questionnaire. Following study variables were recorded at baseline, and after 2 and 4 years: UPDRS part III, UPDRS part IV, l-dopa Equivalent Daily Dose (LEDD), NMS Questionnaire (NMSQuest), and the time occurring from PD diagnosis to the need for l-dopa treatment. Age, gender and disease duration were included as covariates in the statistical models.
The average daily caffeine consumption was 296.1 ± 157.2 mg. At Cox regression models, higher caffeine consumption was associated with a lower rate of starting l-Dopa treatment (HR = 0.630; 95%CI = 0.382-0.996). At the mixed-effects linear regression models considering the whole study period, each additional espresso cup per day (50 mg of caffeine) was more likely associated with 5-point lower UPDRS part III total score (Coef = -0.01; 95%CI = -0.02 to 0.00), with 50% reduced LEDD (Coef = -0.01; 95%CI = -0.15 to 0.00; p = 0.021), and with 5-point lower NMSQuest total score (Coef = -0.01; 95%CI = -0.01 to 0.00), but not with UPDRS part IV total score (Coef = -0.00; 95%CI = -0.00 to 0.00).
Caffeine consumption was associated with a reduced accrual of motor and non-motor disability during 4-year follow-up in de novo PD, highlighting the rationale for using adenosine A2A antagonists since the early phases of PD.
较高的咖啡因摄入量与帕金森病（PD）风险降低以及运动和非运动症状（NMS）更良性的进展相关。本观察性队列研究调查了初发PD患者咖啡因摄入与运动和非运动症状的相关性。
纳入79例新诊断的、未接受过药物治疗的PD患者，并随访4年。通过咖啡因消费问卷计算总的咖啡因摄入量。在基线、2年和4年后记录以下研究变量：统一帕金森病评定量表第三部分（UPDRS part III）、统一帕金森病评定量表第四部分（UPDRS part IV）、左旋多巴等效日剂量（LEDD）、非运动症状问卷（NMSQuest）以及从PD诊断到需要左旋多巴治疗的时间。年龄、性别和病程作为协变量纳入统计模型。
平均每日咖啡因摄入量为296.1±157.2毫克。在Cox回归模型中，较高的咖啡因摄入量与开始使用左旋多巴治疗的较低发生率相关（风险比[HR]=0.630；95%置信区间[CI]=0.382 - 0.996）。在考虑整个研究期的混合效应线性回归模型中，每天每增加一杯浓缩咖啡（含50毫克咖啡因），更有可能使UPDRS第三部分总分降低5分（系数=-0.01；95%CI=-0.02至0.00），LEDD降低50%（系数=-0.01；95%CI=-0.15至0.00；p=0.021），NMSQuest总分降低5分（系数=-0.01；95%CI=-0.01至0.00），但与UPDRS第四部分总分无关（系数=-0.00；95%CI=-0.00至0.00）。
在初发PD患者4年随访期间，咖啡因摄入与运动和非运动功能障碍的累积减少相关，这突出了在PD早期使用腺苷A2A拮抗剂的理论依据。
