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Therapeutic Effect of Levodopa/Carbidopa/Entacapone on Sleep Disturbance in Patients with Parkinson’s Disease

Journal of Movement Disorders 2020년 13권 3호 p.205 ~ 212
박계원, 조성양, 이승현, 황윤수, 이다교, 유호성, 정선주,
소속 상세정보
박계원 ( Park Kye-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
조성양 ( Jo Sung-Yang ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
이승현 ( Lee Seung-Hyun ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
황윤수 ( Hwang Yun-Su ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
이다교 ( Lee Da-Gyo ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
유호성 ( Ryu Ho-Sung ) - Kyungpook National University Hospital Department of Neurology
정선주 ( Chung Sun-Ju ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology

Abstract


Objective: To investigate the efficacy of levodopa/carbidopa/entacapone (LCE) at bedtime for treating sleep disturbance in patients with Parkinson’s disease (PD) with motor fluctuations.

Methods: Participants included 128 PD patients with motor fluctuations. All patients were assessed for motor, nonmotor, and sleep-specific symptoms using the United Parkinson’s Disease Rating Scale (UPDRS), the Korean version of the Nonmotor Symptom Scale, the Parkinson’s Disease Sleep Scale (PDSS), the Epworth Sleepiness Scale, and the Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ). We compared the baseline characteristics of patients with sleep disturbance (PDSS score < 120) and those without sleep disturbance (PDSS score ≥ 120). Thirty-nine patients with sleep disturbance who agreed to take LCE at bedtime completed 3-month follow-ups. We analyzed changes in the scores of motor, nonmotor, and sleep symptom scales over the 3 months.

Results: PD patients with sleep disturbance were at more advanced disease stages and had more severe motor, nonmotor, and sleep symptoms than those without sleep disturbance. Patients who took LCE at night showed improvements in motor (UPDRS part III, p = 0.007) and sleep symptoms (total PDSS, p < 0.001). Sleep features that benefitted from LCE included not only nocturnal motor components but also insomnia (PDSS items 2 and 3, p = 0.005 and p < 0.001) and rapid eye movement behavior disorder (PDSS item 6, p = 0.002; and RBDSQ, p < 0.001).

Conclusion: The use of LCE at bedtime may be a useful treatment for sleep disturbance in advanced PD patients with motor fluctuations.

키워드

Levodopa; Parkinson’s disease; Sleep wake disorders

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