Pergolide restores sleep maintenance but impairs sleep EEG synchronization in patients with restless legs syndrome
Pergolide restores sleep maintenance but impairs sleep EEG synchronization in patients with restless legs syndrome
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DOI：
10.1016/s1389-9457(01)00116-2
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发表时间：
2002-01-01
期刊：
影响因子：
4.8
通讯作者：
Friess, Elisabeth
中科院分区：
文献类型：
--
作者：
Tagaya, Hirokuni;Wetter, Thomas C.;Friess, Elisabeth
背景资料：长效多巴胺D1/D2受体激动剂培高利特的治疗已被证明在降低不宁腿综合征（RLS）患者的周期性腿部运动（PLM）频率方面非常有效。为了进一步研究这种有效的多巴胺能药物对快速眼动（REM）和非REM睡眠EEG的微观结构的影响，我们建立了EEG数据的定量分析。研究组包括15例原发性RLS患者（平均年龄57.1 ± 10.1岁），他们是培高利特与安慰剂双盲随机交叉治疗研究中的一个亚组。结果：培高利特治疗组在SWS过程中诱发δ范围（0.78-3.9 Hz; P < 0.05; t检验）的频谱功率显著降低，PLMs也显著降低。此外，我们观察到在非REM睡眠和第2阶段睡眠期间sigma EEG活动（12.1-14.8 Hz; P < 0.03）减少。视觉睡眠评分显示第2阶段睡眠显著增加（P < 0.005），而觉醒明显减少（P < 0.001）。REM睡眠参数，包括EEG功率谱保持不变。结论：培高利特治疗显着改善RLS患者的睡眠质量，但没有恢复SWS，包括在较低频率的频谱功率。我们的研究结果表明，多巴胺受体激动剂培高利特干扰皮层下机制调节过程中的EEG同步在非REM睡眠。(C)2002 Elsevier Science B. V.保留所有权利。
Background: The treatment with the long-acting dopamine D1/D2 receptor agonist pergolide has been proven as very effective in lowering the frequency of periodic leg movements (PLM) in patients with restless legs syndrome (RLS). To further investigate the influence of this potent dopaminergic drug on the microstructure of rapid eye movement (REM) and non-REM sleep EEG we established a quantitative analysis of the EEG data.Methods: The study group consisted of 15 patients with primary RLS (mean age 57.1 +/- 10.1 years) who were a subgroup of patients within a double-blind randomized crossover treatment study with pergolide versus placebo. The polysomnographic recordings were analyzed visually and submitted to a quantitative EEG analysis (fast Fourier transformation).Results: The pergolide treatment induced a significant reduction of the spectral power in the delta range (0.78-3.9 Hz; P < 0.05; t-test) during SWS, as well as a significant reduction of PLMs. In addition, we observed a decrease in the sigma EEG activity (12.1-14.8 Hz; P < 0.03) during non-REM sleep and stage 2 sleep. The visual sleep scoring revealed a significant increase in stage 2 sleep (P < 0.005), whereas wakefulness was markedly diminished (P < 0.001). The REM sleep parameters including the EEG power spectrum remained unchanged.Conclusions: The treatment with pergolide markedly improved the sleep quality in RLS patients but did not restore SWS including the spectral power in the lower frequencies. Our results suggest that the dopamine agonist pergolide interferes with the subcortical mechanisms regulating the process of EEG synchronization during non-REM sleep. (C) 2002 Elsevier Science B.V. All rights reserved.