Pramipexole
reduces simple motor behaviors
of REM sleep behavior disorder,
according to this study.
Eight
patients with RBD (mean symptom
duration 8.3 years) received baseline
polysomnography and then pramipexole
(mean dosage 0.78 mg/day) at bedtime.
Follow-up PSG occurred at a mean
of 4.5 months.
Seven
patients experienced a reduction
in the frequency, intensity, or
both, of self-reported RBD clinical
manifestations, The effect lasted
only two weeks for two patients,
and was still present at six months
in five patients. The mean number
of REM sleep simple motor behaviors
declined from 139 to 64 (p<0.05).
No other PSG variables changed
significantly, except for atonia,
which decreased unexpectedly from
44.1% to 34.5 % (p <0.02).
The authors
state, "The clinical improvement
observed with dopamine agonist
treatment for patients with currently
idiopathic RBD in the present
study further supports the notion
of a common pathophysiologic mechanism
underlying [RBD and Parkinson's
disease]." In an accompanying
editorial, Jean Matheson and Clifford
Saper state, "it has become
abundantly clear that RBD should
be considered to represent a 'preparkinsonian'
state." Because treatment
did not change periodic limb movements
either during sleep or wakefulness,
they suggest that the pathophysiology
of PLMs may differ between patients
with and without RBD.
Copyright
2003 WE MOVE
|
