Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Clin Neuropharmacol. 2022;45(3):61-64. doi: 10.1097/WNF.0000000000000501.
We hypothesized that rotigotine may have a positive effect on cognitive function in patients with Parkinson disease (PD) by improving daytime motor function and sleep status.
Fifteen PD patients with sleep disturbances, defined as a PD Sleep Scale (PDSS)-2 score of 15 or greater, were included in this single-center, 3-month open-label study. Participants received 2 to 4 mg/24 h (patch content: 4.5-9 mg) rotigotine for a 3-month period. At baseline and 3 months, the patients were evaluated on the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts III and IV and cognitive assessments, such as the Mini-Mental State Examination, frontal assessment battery, and Montreal Cognitive Assessment (MoCA). The Epworth Sleepiness Scale (ESS) and PDSS-2 were administered at baseline and at 1, 2, and 3 months.
At 3 months, the MDS-UPDRS part III (-11.1, P < 0.0001) and MDS-UPDRS part IV (-1.1, P = 0.0013) scores significantly decreased, and off time significantly decreased (-34.6 minutes, P = 0.0085) from baseline. The PDSS-2 scores significantly decreased from baseline at 1 month (-4.2, P < 0.01), 2 months (-7.7, P < 0.0001), and 3 months (-7.3, P < 0.0001). The ESS also decreased at 1 month (-2.5, P < 0.05) and 3 months from baseline (-4.5, P < 0.01). The MoCA scores (1.6, P = 0.0029) significantly improved, but the Mini-Mental State Examination or frontal assessment battery scores did not significantly change. The mean changes from baseline to 3 months in the MoCA were negatively correlated with mean changes in the ESS scores.
We suggest that rotigotine could improve cognitive function by improving motor symptoms, sleep disturbance, and daytime sleepiness in patients with PD.
我们假设罗替戈汀可能通过改善日间运动功能和睡眠状态对帕金森病（PD）患者的认知功能产生积极影响。
本单中心、3 个月开放性研究纳入了 15 例伴有睡眠障碍的 PD 患者，其 PD 睡眠量表（PDSS）-2 评分为 15 或更高。参与者接受 2 至 4 毫克/24 小时（贴剂含量：4.5-9 毫克）罗替戈汀治疗 3 个月。在基线和 3 个月时，患者接受运动障碍协会修订的统一 PD 评定量表（MDS-UPDRS）第三和第四部分以及认知评估，如简易精神状态检查、额叶评估量表和蒙特利尔认知评估（MoCA）。在基线和 1、2 和 3 个月时进行 Epworth 嗜睡量表（ESS）和 PDSS-2 评估。
3 个月时，MDS-UPDRS 第三部分（-11.1，P<0.0001）和 MDS-UPDRS 第四部分（-1.1，P=0.0013）评分显著降低，并且从基线开始的无运动时间显著减少（-34.6 分钟，P=0.0085）。PDSS-2 评分从基线开始在 1 个月（-4.2，P<0.01）、2 个月（-7.7，P<0.0001）和 3 个月（-7.3，P<0.0001）显著降低。ESS 评分也从基线开始在 1 个月（-2.5，P<0.05）和 3 个月（-4.5，P<0.01）时降低。MoCA 评分（1.6，P=0.0029）显著改善，但简易精神状态检查或额叶评估量表评分没有显著变化。从基线到 3 个月时 MoCA 的平均变化与 ESS 评分的平均变化呈负相关。
我们认为罗替戈汀可以通过改善 PD 患者的运动症状、睡眠障碍和白天嗜睡来改善认知功能。
