SLEEP ELECTROENCEPHALOGRAPHY AND THE CLINICAL-RESPONSE TO AMITRIPTYLINE IN PATIENTS WITH FIBROMYALGIA
SLEEP ELECTROENCEPHALOGRAPHY AND THE CLINICAL-RESPONSE TO AMITRIPTYLINE IN PATIENTS WITH FIBROMYALGIA
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DOI：
10.1002/art.1780380906
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发表时间：
1995-09-01
影响因子：
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通讯作者：
STERIADE, M
中科院分区：
文献类型：
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作者：
CARETTE, S;OAKSON, G;STERIADE, M
目的：确定纤维肌痛患者非快速眼动（NREM）睡眠期间α频带脑电图（EEG）异常的患病率和临床相关性，并评估α非快速眼动睡眠异常作为阿米替林反应的预测因子。方法：对22例纤维肌痛患者进行为期2个月的双盲交叉试验，阿米替林（25mg /天）与安慰剂对照，在基线和每2个月治疗期结束时连续2晚进行夜间脑电图。结果：阿米替林对6例患者（27%）有临床反应，安慰剂组无反应（P = 0.02），阿米替林或安慰剂组在非快速眼动睡眠时α评分没有任何变化，只有8例患者（36%）在基线时表现出非快速眼动睡眠α异常，这些患者报告更多的睡眠困难，但在临床上与没有这种脑电图睡眠异常的患者无法区分。阿米替林应答者的基线α - NREM睡眠评分低于无应答者，但这些差异没有达到统计学意义。结论：α - NREM睡眠异常仅存在于一小部分纤维肌痛患者中，与疾病严重程度无关，阿米替林治疗不影响α - NREM睡眠异常。需要更大的样本量来充分评估这种睡眠异常在预测阿米替林反应中的价值。
Objective, To determine the prevalence and clinical correlations of an anomaly consisting of electroencephalographic (EEG) waves within the alpha frequency band during non-rapid eye movement (NREM) sleep in patients with fibromyalgia, and to evaluate the alpha NREM sleep anomaly as a predictor of response to amitriptyline.Methods, Twenty-two patients with fibromyalgia were studied in a 2-month, double-blind, crossover trial of amitriptyline (25 mg/day) versus placebo, Nocturnal EEGs were conducted on 2 consecutive nights at baseline and at the end of each 2-month treatment period.Results, Six patients (27%) had a clinical response to amitriptyline, while none responded to placebo (P = 0.02), Treatment with amitriptyline or placebo did not result in any changes in the alpha ratings during NREM sleep, Only 8 patients (36%) exhibited the alpha NREM sleep anomaly at baseline, Those patients reported more sleep difficulty, but otherwise were clinically indistinguishable from those without this EEG sleep anomaly, Lower baseline alpha NREM sleep ratings were seen in responders to amitriptyline than in nonresponders, but these differences did not reach statistical significance.Conclusion, The alpha NREM sleep anomaly is present in only a small proportion of patients with fibromyalgia, It does not correlate with disease severity nor is it affected by treatment with amitriptyline. A larger sample size will be needed to adequately assess the value of this sleep anomaly in predicting the response to amitriptyline.