Zibetti Maurizio, Romagnolo Alberto, Merola Aristide, Priano Lorenzo, Montanaro Elisa, Angrisano Serena, Tribolo Antonella, Cicolin Alessandro, Lopiano Leonardo
Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124, Turin, Italy.
Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
J Neurol. 2017 Jun;264(6):1085-1090. doi: 10.1007/s00415-017-8491-2. Epub 2017 Apr 19.
Sleep disorders are very common in advanced Parkinson's disease (PD) and have a significant negative impact on the quality of life of patients. Questionnaire-based studies suggest that sleep quality might improve following levodopa-carbidopa intestinal gel (LCIG) infusion. The objective of this study was to evaluate the impact of LCIG infusion and subsequent oral medication changes on polysomnography (PSG) and sleep symptoms in advanced PD patients. Eleven PD patients underwent PSG at baseline and after 3.8 ± 1.2 months of LCIG treatment. LCIG infusion therapy was halted during PSG. Patients were assessed with the Unified-PD-rating-Scale and completed the PD-Sleep-Scale-version-2 (PDSS-2), the Epworth Sleepiness Scale and the RBD single question. Subjective sleep quality improved in all patients. PSG showed a reduction of the number of awakenings in sleep, a trend towards a lower apnea-hypopnea index and no change in sleep latency, total sleep time and sleep efficiency. There was a positive correlation between the number of awakenings and PDSS-2 scores for "difficulty staying asleep", "muscle cramps of arms or legs" and "urge to move arms or legs". Motor complications and activities of daily living improved with LCIG. Subjective sleep quality improved significantly and the PSG study showed a less fragmented sleep pattern in advanced PD patients treated with LCIG infusion.
睡眠障碍在晚期帕金森病（PD）中非常常见，对患者的生活质量有显著负面影响。基于问卷的研究表明，左旋多巴 - 卡比多巴肠凝胶（LCIG）输注后睡眠质量可能会改善。本研究的目的是评估LCIG输注及随后口服药物变化对晚期PD患者多导睡眠图（PSG）和睡眠症状的影响。11例PD患者在基线时及接受LCIG治疗3.8±1.2个月后进行了PSG检查。PSG检查期间停止LCIG输注治疗。患者接受统一帕金森病评定量表评估，并完成帕金森病睡眠量表第2版（PDSS - 2）、爱泼华嗜睡量表和快速眼动睡眠行为障碍单项问题调查。所有患者的主观睡眠质量均有所改善。PSG显示睡眠中觉醒次数减少，呼吸暂停低通气指数有降低趋势，而睡眠潜伏期、总睡眠时间和睡眠效率无变化。觉醒次数与PDSS - 2中“难以入睡”、“手臂或腿部肌肉痉挛”和“手臂或腿部异动冲动”的评分之间存在正相关。LCIG治疗后运动并发症和日常生活活动能力得到改善。主观睡眠质量显著改善，PSG研究显示接受LCIG输注治疗的晚期PD患者睡眠模式的碎片化程度降低。
