Bušek Petr, Bušková Jitka, Miletínová Eva, Mladá Karolína, Nevšímalová Soňa, Šonka Karel
National Institute of Mental Health, Klecany.
Clin Neuropharmacol. 2018 Jul/Aug;41(4):111-115. doi: 10.1097/WNF.0000000000000287.
Modafinil may affect autonomic functions in healthy subjects. The aim of the study was to assess the long-term modafinil administration influence on the cardiac autonomic reactivity to orthostatic load in patients with narcolepsy type 1.
In 15 patients (4 male; 11 female; median age, 47 years; range, 18-70 years) with narcolepsy type 1 treated with modafinil in daily dose of 100 to 300 mg, the short-term spectral analysis of heart rate variability (HRV) in supine-standing-supine test was performed before and after 72 hours of modafinil discontinuation.
The sympathovagal reactivity to orthostatic load was not modified by modafinil treatment; nevertheless, the parasympathetic activity expressed by length of R-R interval and high-frequency component of HRV is reduced in supine position in patients taking modafinil.
We conclude that long-term use of modafinil does not influence the cardiac autonomic reactivity to orthostatic load expressed by the HRV changes in supine-standing-supine test in narcolepsy type 1 patients, but the parasympathetic cardiac activity may be reduced in quiet supine position in patients with narcolepsy taking modafinil.
莫达非尼可能会影响健康受试者的自主神经功能。本研究的目的是评估长期服用莫达非尼对1型发作性睡病患者心脏自主神经对直立负荷反应性的影响。
对15例1型发作性睡病患者（4例男性，11例女性；年龄中位数47岁，范围18 - 70岁）进行研究，这些患者每日服用100至300毫克莫达非尼，在停用莫达非尼72小时前后，对其进行仰卧 - 站立 - 仰卧试验中的心率变异性（HRV）短期频谱分析。
莫达非尼治疗并未改变对直立负荷的交感迷走神经反应性；然而，服用莫达非尼的患者在仰卧位时，由R - R间期长度和HRV高频成分所表示的副交感神经活动降低。
我们得出结论，长期使用莫达非尼不会影响1型发作性睡病患者在仰卧 - 站立 - 仰卧试验中由HRV变化所表示的心脏自主神经对直立负荷的反应性，但服用莫达非尼的发作性睡病患者在安静仰卧位时副交感神经心脏活动可能会降低。
