Circadian changes in CSF dopaminergic measures in restless legs syndrome
Circadian changes in CSF dopaminergic measures in restless legs syndrome
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DOI：
10.1016/j.sleep.2005.09.006
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发表时间：
2006-04-01
期刊：
影响因子：
4.8
通讯作者：
Allen, Richard P.
中科院分区：
文献类型：
--
作者：
Earley, Christopher J.;Hyland, Keith;Allen, Richard P.
背景和目的：不宁腿综合征（RLS）具有昼夜节律成分，症状在夜间突出。多巴胺能（DAergic）系统在RLS中发挥作用，需要与RLS症状变化平行的昼夜节律变化。这项研究的目的是寻找能量活动的相对差异和日差异。患者和方法：所有RLS患者在入组前接受治疗，但在评估前至少2周无药物。晚上10点采集脑脊液（CSF）用于测定da相关的辅助因子和代谢物。这些数据与之前在上午10点收集的脑脊液值进行了比较。结果：在晚上10点的样本中（30例RLS； 22例对照组），唯一显著的发现是与对照组相比，RLS的3-正甲基多巴（3OMD）增加。比较晚上10点和上午10点的值（16个RLS； 9个对照组）显示，对照组的昼夜变化较小，不显著，但RLS的四氢生物蝶呤（BH4）， HVA:5HIAA比率和3OMD的昼夜变化较大，上午10点的样本显示，与晚上10点的样本相比，所有三个CSF因子都有所增加。结论：与正常人相比，RLS患者的昼夜变化更大，表明其能量昼夜动力学波动更大。在没有外源性左旋多巴的情况下，3OMD浓度升高表明RLS中左旋多巴的合成或代谢发生了变化。(C) 2005 Elsevier B.V.版权所有
Background and purpose: Restless legs syndrome (RLS) has a circadian component with symptoms being prominent at night. The dopaminergic (DAergic) system, which plays a role in RLS, entails circadian changes that parallel RLS symptom changes. The aim of this study was to look for relative and diurnal differences in DAergic activity.Patients and methods: All RLS subjects were treated prior to their enrollment in the study but were all drug-free for at least 2 weeks prior to evaluation. Cerebrospinal fluid (CSF) collected at 10 p.m. was used to determine DA-related co-factors and metabolites. These were compared to CSF values collected in a previous study at 10 a.m.Results: The only significant finding from the 10 p.m. samples (30 RLS; 22 control) was increased 3-ortho-methyldopa (3OMD) for RLS compared to controls. A comparison of the 10 p.m. to 10 a.m. values (16 RLS; 9 controls) showed small, non-significant diurnal changes for controls but large diurnal changes in tetrahydrobiopterin (BH4), HVA:5HIAA ratio and 3OMD for RLS, with the 10 a.m. sample showing increases in all three CSF factors compared to the 10 p.m. sample.Conclusions: The greater diurnal changes in RLS suggest greater fluctuations than normal in DAergic circadian dynamics. The increased 3OMD concentration in the absence of concurrent exogenous levodopa (L-dopa) suggests changes in synthesis or metabolism Of L-dopa in RLS. (C) 2005 Elsevier B.V. All rights reserved.