Circadian effects of dopaminergic, treatment in restless legs syndrome
Circadian effects of dopaminergic, treatment in restless legs syndrome
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DOI：
10.1016/j.sleep.2004.01.007
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发表时间：
2004-07-01
期刊：
影响因子：
4.8
通讯作者：
Granizo, JJ
中科院分区：
文献类型：
--
作者：
Garcia-Borreguero, D;Serrano, C;Granizo, JJ
背景和目的：尽管不宁腿综合征（RLS）的基本诊断特征是存在昼夜节律症状变化，在晚上或夜间增加，但这种时间限制变化的机制尚不清楚。由于多巴胺能机制似乎在RLS的病理生理中起着核心作用，很可能是多巴胺能系统的昼夜变化或影响它的因素导致夜间增加。多巴胺类药物可能会影响褪黑激素的功能，褪黑激素是昼夜节律系统的关键元素。本研究探讨多巴胺能药物对RLS中褪黑激素分泌的影响。患者和方法：8名未经治疗的特发性RLS患者接受了为期3周的开放标记治疗，给予400mg左旋多巴（+ 100mg卡比多巴）。昏暗灯光褪黑素发作（DLMO），昼夜节律阶段的标志，测定治疗前后。结果：与基线相比，左旋多巴治疗组DLMO发生时间更早（21:00 +/- 1:20 vs. 18:50 +/- 0:55; P < 0.05）。对DLMO的预期在增大的患者亚组中更为明显。左旋多巴治疗后DLMO、睡眠潜伏期变化与症状发作时间呈正相关。结论：我们的研究结果提示左旋多巴可能在RLS中发挥时间生物作用。(C) 2004 Elsevier B.V.版权所有
Background and purpose: Although an essential diagnostic feature of restless legs syndrome (RLS) is the presence of circadian symptom variations, with an increase in the evening or at night, the mechanisms underlying this time-bound variation remain unknown. Since dopaminergic mechanisms seem to play a central role in the pathophysiology of RLS, it is likely that circadian variations in the dopaminergic system or factors affecting it cause the nightly increase-The reverse is also possible; dopaminergic medication might affect melatonin function, a key element of the circadian system. The present study investigated the effects of dopaminergic medication on melatonin secretion in RLS.Patients and methods: Eight previously untreated patients diagnosed with idiopathic RLS underwent a three-week, open-labeled treatment with 400 mg L-DOPA (+ 100 mg CarbiDOPA). Dim Light Melatonin Onset (DLMO), a marker of circadian phase, was determined before and after treatment.Results: Compared to baseline, earlier DLMO was found in L-DOPA treated patients (21:00 +/- 1:20 vs. 18:50 +/- 0:55; P < 0.05). Anticipation of DLMO was more marked in the subgroup of patients showing augmentation. A positive correlation was observed between change of DLMO, sleep latency and time of onset of symptoms following treatment with L-DOPA.Conclusions: Our results suggest that L-DOPA may exert chronobiotic effects in RLS. (C) 2004 Elsevier B.V. All rights reserved.