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苯二氮䓬类药物是否会损害帕金森病患者样本中的运动和非运动症状?

Do Benzodiazepines Impair Motor and Nonmotor Symptoms in a Sample of Parkinson's Disease Patients?

作者信息

Gaztanaga Wendy, Sarno Marina, Margolesky Jason, Luca Corneliu, Singer Carlos, Moore Henry, Jagid Jonathan, Levin Bonnie

机构信息

Neurology, University of Miami, Miami, USA.

Neurological Surgery, University of Miami, Miami, USA.

出版信息

Cureus. 2021 Feb 8;13(2):e13220. doi: 10.7759/cureus.13220.

Abstract

Background Anxiety and sleep disturbances are prevalent in Parkinson's disease (PD). Benzodiazepines (BZDs) are commonly used to treat these symptoms; however, they are associated with unfavorable side effects such as falls and cognitive slowing in the general non-PD population. Examining the effects of BZDs in PD is imperative as these medications could pose an increased risk to PD patients who are already vulnerable to falls and cognitive deficits. Methods Eighty-four patients diagnosed with idiopathic PD, of which 60% were Hispanic, underwent clinical evaluations including the Unified Parkinson's Disease Rating Scale (UPDRS) and comprehensive neuropsychological testing examining global cognition, language, visuospatial skills, memory, executive function, mood, and sleep quality. Thirty-six patients taking BZDs (BZD+) were compared to forty-eight patients not using any BZDs (BZD-) employing appropriate statistical tests depending on the measures' characteristics. Results BZD+ PD patients performed below the BZD- group on short-term memory but not on delayed recall, and performed better on a measure of visuospatial judgment. The BZD+ group endorsed more symptoms of anxiety and depression as well as poorer sleep quality. No significant differences were noted on other measures of cognition or motor function. Conclusion PD patients taking BZDs may experience select changes in cognition and mood. These changes are isolated and mild, and suggest that for some patients, BZDs may be a viable pharmacologic intervention that does not alter cognitive and motor function compared to those not taking these medications.

摘要

背景

焦虑和睡眠障碍在帕金森病(PD)中很常见。苯二氮䓬类药物(BZDs)常用于治疗这些症状;然而,在一般非PD人群中,它们与跌倒和认知迟缓等不良副作用相关。鉴于这些药物可能会给已经容易跌倒和出现认知缺陷的PD患者带来更高风险,因此研究BZDs在PD中的作用势在必行。方法:84名被诊断为特发性PD的患者接受了临床评估,其中60%为西班牙裔,评估包括统一帕金森病评定量表(UPDRS)以及全面的神经心理学测试,以检查整体认知、语言、视觉空间技能、记忆、执行功能、情绪和睡眠质量。根据测量指标的特点,采用适当的统计检验方法,将36名服用BZDs的患者(BZD+)与48名未使用任何BZDs的患者(BZD-)进行比较。结果:BZD+的PD患者在短期记忆方面表现低于BZD-组,但在延迟回忆方面没有差异,并且在视觉空间判断测量中表现更好。BZD+组认可更多的焦虑和抑郁症状以及更差的睡眠质量。在其他认知或运动功能测量中未发现显著差异。结论:服用BZDs的PD患者可能会在认知和情绪方面出现特定变化。这些变化是孤立且轻微的,这表明对于一些患者来说,与未服用这些药物的患者相比,BZDs可能是一种可行的药物干预措施,不会改变认知和运动功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/7945787/d7da7ff51cd7/cureus-0013-00000013220-i01.jpg

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