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Pathophysioiogy of antipsycbotic induced extra pyramidal reactions by the use ofPLM (sleeping myoclonus) index

使用PLM（睡眠肌阵挛）指数进行抗精神病药物引起的锥体外系反应的病理生理学

基本信息

批准号：
18603004
负责人：
HORIGUCHI Jun
金额：
$ 2.12万
依托单位：
Shimane University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18603004/
关键词：
Periodic Limb Movement Neuroloptics Extrapvramidal symptom

项目摘要

We studied the following which is follows our plan during 2006-07 (H18-H19) year period of study.1) 2007 (H19) period We used overnight polysomnography for 10 new patients (3 patients with Idiopathic hypersomnia, 2 patients with Narcolepsy, 1 patient each with DSPS, Extended sleep, Sleep apnea syndrome, Epilepsia, Unexplained sleep disorder: The average age of patients 26.8±12.2 years old). The average of 10 nights sleep structural findings were Time in bed 487.3 ±42.2 minutes, Sleep period time 486.6 ± 59.2 minutes, Total sleep time 446.6±62.3 minutes, Sleep efficiency 85.2±5.4%, Sleep latency 24.7±11.6minutes. The rate of each sleep stage in sleep period time were Wake9.48±24.6%, REM14.7±3.2%, Stagel 17.3±5.6%, Stage2 50.4±6.8%, Stage3 3.9±1.4%, Stage4 4.1±9.2%.2) 2006 (H18) period(1)The result of sleep parameter for 10 patients (2 patients with tardive dyskinesia, 2 patients with restless legs syndrome, 4 patients with Lewy Body Disease, 2 patients with Alzheimer's disease: The aver … More age age of patients 69.1±11.2 years old). The average of 10 nights sleep structural findings were Time in bed 554.5±54.1minutes, Sleep period time 498.1±54.4minutes, Total sleep time 401.6±74.5minutes, Sleep efficiency 66.6±4.3%, Sleep latency 29.5±15.6minutes. The rate of each sleep stage in sleep period time were Wake 17.67±11.9%, REM6.5±3.1%, Stagel 13.4±11.1%, Stage2 58.7±14.6%, Stage3 1.1±2.0%, Stage4 0.4±0.1%. PLM (sleeping myoclonus) index was 143.23± 212.96.(2) The change of PLM index before and after medication We gave medication to 8 of 10 patients. Single agent of clonazepam was effective with 3 patients. Clonazepam with pergolide mesilate was effective with 1 patient. Yi-Gan-San was effective with 1 patient. The administration of iron to patients was effective with 3 patients.(3)We weighted the result of sleep polysomnography before and after administering iron to 3 patients. All patients resolved subjective symptoms after administration of iron, their PLM index was significantly lower than before. 3) We gave same test to 10 normal adults. They didn't have any change of PLM index between control night and examination night with medication.Result PLM is strongly associated with sleep-wake cycle disorder. It is also associated with the prevalence of antipsychotic induced extrapyramidal symptoms. We strongly suggest that administration of iron to those patients effected to tardive dyskinesia and also it is possibly introduced to algorithm in medication of extrapyramidal symptoms. Less

我们在2006-07（H18-H19）年的研究期间研究了以下内容。1）2007（H19）期间我们对10名新患者进行了夜间多导睡眠图检查（3例特发性嗜睡患者，2例发作性睡病患者，各1例DSPS患者，长时间睡眠，睡眠呼吸暂停综合征，癫痫，不明原因的睡眠障碍：患者平均年龄26.8±12.2岁）。10个夜晚睡眠结构的平均值为：卧床时间487.3 ±42.2分钟，睡眠时间486.6 ± 59.2分钟，总睡眠时间446.6±62.3分钟，睡眠效率85.2± 5.4%，睡眠潜伏期24.7± 11.6分钟。各睡眠阶段在睡眠期时间内的发生率分别为：清醒期9.48 ± 24.6%，REM期14.7 ± 3.2%，1期17.3± 5.6%，2期50.4± 6.8%，3期3.9± 1.4%，4期4.1± 9.2%。2例不宁腿综合征患者，4例路易体病患者，2例阿尔茨海默病患者： ...更多信息患者年龄69.1±11.2岁）。10个夜晚睡眠结构的平均值为：卧床时间554.5± 54.1分钟，睡眠时间498.1± 54.4分钟，总睡眠时间401.6± 74.5分钟，睡眠效率66.6± 4.3%，睡眠潜伏期29.5± 15.6分钟。各睡眠阶段在睡眠时间内所占比例分别为：清醒17.67± 11.9%，REM 6.5 ± 3.1%，第1阶段13.4± 11.1%，第2阶段58.7± 14.6%，第3阶段1.1± 2.0%，第4阶段0.4± 0.1%。睡眠肌阵挛指数（PLM）为143.23± 212.96。(2)药物治疗前后PLM指数的变化10例患者中8例给予药物治疗。氯硝西泮单药治疗3例有效。氯硝西泮联合甲磺酸培高利特对1例患者有效。益肝散有效1例。3例患者的铁剂给药有效。(3)We对3例患者补铁前后的睡眠多导睡眠图结果进行加权。所有患者在补铁后主观症状均缓解，PLM指数明显低于补铁前。3)我们对10名正常成年人进行了同样的测试。结果PLM与睡眠-觉醒周期紊乱密切相关。它也与抗精神病药诱发的锥体外系症状的患病率相关。我们强烈建议对这些患者给予铁剂对迟发性运动障碍有影响，并可能将其引入锥体外系症状的药物治疗中。少