Caffeine for treatment of Parkinson disease A randomized controlled trial

被引:204
|
作者
Postuma, Ronald B. [1 ]
Lang, Anthony E. [2 ,3 ]
Munhoz, Renato P. [4 ]
Charland, Katia [5 ]
Pelletier, Amelie [1 ,6 ]
Moscovich, Mariana [4 ]
Filla, Luciane [4 ]
Zanatta, Debora [4 ]
Romenets, Silvia Rios [1 ]
Altman, Robert [1 ]
Chuang, Rosa [2 ,3 ]
Shah, Binit [2 ,3 ]
机构
[1] McGill Univ, Montreal Gen Hosp, Dept Neurol, Montreal, PQ H3G 1A4, Canada
[2] Univ Toronto, Toronto Western Hosp, Morton & Gloria Shulman Movement Disorders Ctr, Toronto, ON M5T 2S8, Canada
[3] Univ Toronto, Toronto Western Hosp, Edmond J Safra Program Parkinsons Dis, Toronto, ON M5T 2S8, Canada
[4] Pontificia Univ Catolica Parana, Curitiba, Parana, Brazil
[5] McGill Univ, Montreal, PQ, Canada
[6] McGill Univ, Neuroepidemiol Res Unit, Res Inst, Ctr Hlth, Montreal, PQ, Canada
关键词
DAYTIME SLEEPINESS; DOUBLE-BLIND; ADENOSINE; ISTRADEFYLLINE; ANTAGONISTS; MODAFINIL; LEVODOPA; SCALE; RISK;
D O I
10.1212/WNL.0b013e318263570d
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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 x 3 weeks, then 200 mg twice daily x 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. Neurology (R) 2012;79:651-658
引用
收藏
页码:651 / 658
页数:8
相关论文
共 50 条
  • [41] A Phase 2 Randomized Controlled Trial Repurposing Ambroxol as a Disease Modifying Treatment for Parkinson's disease Dementia.
    Pasternak, S. H.
    Silviera, C.
    Coleman, K.
    Finger, E.
    Wells, J.
    Borrie, M.
    Morrow, S.
    Zou, G.
    Bartha, R.
    Macdonald, P.
    Jenkins, M. E.
    Jog, M.
    Tirona, R.
    Rupar, C. A.
    MOVEMENT DISORDERS, 2021, 36 : S189 - S190
  • [42] Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial
    Raj Prakash
    Femitha Pournami
    Jyothi Prabhakar
    Anand Nandakumar
    P. M. C. Nair
    Naveen Jain
    Indian Journal of Pediatrics, 2021, 88 : 1174 - 1179
  • [43] Caffeine for the Treatment of Apnea in Bronchiolitis: A Randomized Trial
    Alansari, Khalid
    Toaimah, Fatihi Hassan
    Khalafalla, Hany
    El Tatawy, Lamiaa Awny
    Davidson, Bruce L.
    Ahmed, Wessam
    JOURNAL OF PEDIATRICS, 2016, 177 : 204 - +
  • [44] CAFFEINE FOR THE TREATMENT OF APNEA IN BRONCHIOLITIS: A RANDOMIZED TRIAL
    Al-Ansari, K.
    Toaimah, F. Fatihi Hassan
    Khalafalla, H.
    El Tatawy, L. Awny
    Davidson, B. L.
    Ahmed, W.
    EUROPEAN JOURNAL OF PEDIATRICS, 2016, 175 (11) : 1513 - 1513
  • [45] Intravenous amantadine on freezing of gait in Parkinson's disease: a randomized controlled trial
    Lee, Jee Young
    Oh, Sohee
    Kim, Jong Min
    Kim, Ji Sun
    Oh, Eungseok
    Kim, Hee-Tae
    Jeon, Beom S.
    Cho, Jin Whan
    JOURNAL OF NEUROLOGY, 2013, 260 (12) : 3030 - 3038
  • [46] Intravenous amantadine on freezing of gait in Parkinson’s disease: a randomized controlled trial
    Jee Young Lee
    Sohee Oh
    Jong Min Kim
    Ji Sun Kim
    Eungseok Oh
    Hee-Tae Kim
    Beom S. Jeon
    Jin Whan Cho
    Journal of Neurology, 2013, 260 : 3030 - 3038
  • [47] Bladder training for urinary tract symptoms in Parkinson disease: A randomized controlled trial
    McDonald, Claire
    Rees, Jackie
    Winge, Kristian
    Newton, Julia L.
    Burn, David J.
    NEUROLOGY, 2020, 94 (13) : E1427 - E1433
  • [48] Managing Fatigue in Parkinson's Disease: Protocol for a Pilot Randomized Controlled Trial
    Alizadeh, Neda
    Packer, Tanya L.
    Sturkenboom, Ingrid
    Eskes, Gail
    Warner, Grace
    CANADIAN JOURNAL OF OCCUPATIONAL THERAPY-REVUE CANADIENNE D ERGOTHERAPIE, 2022, 89 (02): : 180 - 189
  • [49] Benefit of music therapy in patients with Parkinson's disease: A randomized controlled trial
    Shankar, A.
    de Brain, N.
    Bonfield, S.
    Derwent, L.
    Eliasziw, M.
    Hu, B.
    Brown, L.
    Suchowersky, O.
    MOVEMENT DISORDERS, 2008, 23 (01) : S201 - S201
  • [50] Resistance Training on Postural Control in Parkinson's Disease: a Randomized Controlled Trial
    Souza, C.
    Chen, J.
    Francato, D.
    Barbosa, A.
    Voos, M.
    Barbosa, E.
    Chien, H.
    MOVEMENT DISORDERS, 2020, 35 : S420 - S420