Neurology：喝咖啡或有助于改善帕金森疾病患者运动症状

根据一项于2012年8月1日在线发表在Neurology期刊上的新研究，尽管每天和咖啡似乎并不有助于改善帕金森疾病患者的睡眠，但是它可能有助于控制他们的运动。

在这项研究中，61名表现出日间嗜睡和一些运动症状的帕金森患者首先在3周内每天两次服用安慰剂或者100mg咖啡，然后再在3周内每天两次服用200mg咖啡，其中200mg咖啡相当于每天喝2到4杯咖啡。

6周之后，服用咖啡添加剂的一半患者在帕金森疾病严重性等级评定中要比不消耗咖啡的患者平均产生五点改善。论文通讯作者Ronald Postuma博士说，“尽管这是一个适度的改善，但是可能足够给患者带来益处。另一方面，它可能不足以解释不使用咖啡和帕金森疾病之间的关系，这是因为对帕金森疾病早期症状发展的研究提示着下降5点只能延迟疾病诊断6个月的时间。”

6周之后，服用咖啡添加剂的一半患者在帕金森疾病严重性等级评定中要比不消耗咖啡的患者平均产生五点改善。论文通讯作者Ronald Postuma博士说，“尽管这是一个适度的改善，但是可能足够给患者带来益处。另一方面，它可能不足以解释不使用咖啡和帕金森疾病之间的关系，这是因为对帕金森疾病早期症状发展的研究提示着下降5点只能延迟疾病诊断6个月的时间。”

这项研究特别令人感兴趣，这是因为咖啡似乎阻断帕金森患者发生故障的大脑信号，因而是一种安全和便宜的方法。研究人员注意到，研究时间比较短，因此咖啡的影响可能随着时间的变长而减弱。

本文编译自A cup of joe may help some Parkinson's disease symptoms

doi: 10.1212/WNL.0b013e318263570d
PMC:
PMID:

Caffeine for treatment of Parkinson disease A randomized controlled trial

Ronald B. Postuma, MD, MSc, Anthony E. Lang, MD, Renato P. Munhoz, MD, Katia Charland, PhD, Amelie Pelletier, PhD, Mariana Moscovich, MD, Luciane Filla, MD, Debora Zanatta, RPh, Silvia Rios Romenets, MD, Robert Altman, MD, Rosa Chuang, MD and Binit Shah, MD

Objective: Epidemiologic studies consistently link caffeine, a nonselective adenosine antagonist, to lower risk of Parkinson disease (PD). However, the symptomatic effects of caffeine in PD have not been adequately evaluated. Methods: We conducted a 6-week randomized controlled trial of caffeine in PD to assess effects upon daytime somnolence, motor severity, and other nonmotor features. Patients with PD with daytime somnolence (Epworth >10) were given caffeine 100 mg twice daily ×3 weeks, then 200 mg twice daily ×3 weeks, or matching placebo. The primary outcome was the Epworth Sleepiness Scale score. Secondary outcomes included motor severity, sleep markers, fatigue, depression, and quality of life. Effects of caffeine were analyzed with Bayesian hierarchical models, adjusting for study site, baseline scores, age, and sex. Results: Of 61 patients, 31 were randomized to placebo and 30 to caffeine. On the primary intention-to-treat analysis, caffeine resulted in a nonsignificant reduction in Epworth Sleepiness Scale score (−1.71 points; 95% confidence interval [CI] −3.57, 0.13). However, somnolence improved on the Clinical Global Impression of Change (+0.64; 0.16, 1.13, intention-to-treat), with significant reduction in Epworth Sleepiness Scale score on per-protocol analysis (−1.97; −3.87, −0.05). Caffeine reduced the total Unified Parkinson's Disease Rating Scale score (−4.69 points; −7.7, −1.6) and the objective motor component (−3.15 points; −5.50, −0.83). Other than modest improvement in global health measures, there were no changes in quality of life, depression, or sleep quality. Adverse events were comparable in caffeine and placebo groups. Conclusions: Caffeine provided only equivocal borderline improvement in excessive somnolence in PD, but improved objective motor measures. These potential motor benefits suggest that a larger long-term trial of caffeine is warranted. Classification of evidence: This study provides Class I evidence that caffeine, up to 200 mg BID for 6 weeks, had no significant benefit on excessive daytime sleepiness in patients with PD.

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