Privação de sono total na doença de Parkinson

Bertolucci, Paulo H. F.; Andrade, Luiz A. F.; Lima, José G. C.; Cajilini, E. A.

doi:10.1590/S0004-282X1987000300002

Resumos

Doze pacientes com doença de Parkinson (DP) foram submetidos a privação de sono total. A média de idade dos pacientes era 61 anos e a duração da doença era em média de 5,1 anos (1,5 a 12 anos). Quatro deles usavam apenas anticolinérgico, 4 usavam L-Dopa e 4 combinação de drogas de ambos os grupos. Após privação de sono total por uma única noite foi verificada melhora na rigidez, bradicinesia, alterações de postura e marcha e incapacidade funcional com duração de duas semanas, em comparação com os escores quando da inclusão no estudo. Não foi observado efeito sobre o tremor. Em relação aos sintomas depressivos foi verificada melhora com duração de apenas uma semana. Estes resultados sugerem efeito benéfico da privação de sono na DP. Com base em estudos experimentais julgamos que uma explicação possível para estes resultados seja a modificação de receptores dopaminérgicos.

Twelve Parkinson disease (PD) patients were submitted to a single night of total sleep deprivation (SD). Disease duration had a median of 5.1 years and all were using either anticholinergic or L-Dopa or the combination of both drugs. After SD there was an improvement of rigidity, bradykinesia, gait and posture disturbances and functional disability that remained significant for 2 weeks. No effect was observed on tremor. Concerning depressive symptoms, a significant difference was noted, that remained for one week. These results suggest that SD may be an useful procedure to improve PD symptomatology. It is discussed a possible change of dopaminergic receptors, induced by SD, to explain the improvement.

Total sleep deprivation and Parkinson disease

Privação de sono total na doença de Parkinson

Paulo H. F. Bertolucci^I; Luiz A. F. Andrade^I; José G. C. Lima^I; E. A. Cajilini^II

^IDepartment of Neurology and Neurosurgery - Escola Paulista de Medicina, São Paulo, Brazil. This work was partialy supported by CNPq and FINER P.H.F.B. was a fellow of FAPESP (Proc. 83/1307-5). This work received the Parkinsonism Sandoz Award (1986)

^IIPsychobiology - Escola Paulista de Medicina, São Paulo, Brazil. This work was partialy supported by CNPq and FINER P.H.F.B. was a fellow of FAPESP (Proc. 83/1307-5). This work received the Parkinsonism Sandoz Award (1986)

SUMMARY

Twelve Parkinson disease (PD) patients were submitted to a single night of total sleep deprivation (SD). Disease duration had a median of 5.1 years and all were using either anticholinergic or L-Dopa or the combination of both drugs. After SD there was an improvement of rigidity, bradykinesia, gait and posture disturbances and functional disability that remained significant for 2 weeks. No effect was observed on tremor. Concerning depressive symptoms, a significant difference was noted, that remained for one week. These results suggest that SD may be an useful procedure to improve PD symptomatology. It is discussed a possible change of dopaminergic receptors, induced by SD, to explain the improvement.

RESUMO

Doze pacientes com doença de Parkinson (DP) foram submetidos a privação de sono total. A média de idade dos pacientes era 61 anos e a duração da doença era em média de 5,1 anos (1,5 a 12 anos). Quatro deles usavam apenas anticolinérgico, 4 usavam L-Dopa e 4 combinação de drogas de ambos os grupos. Após privação de sono total por uma única noite foi verificada melhora na rigidez, bradicinesia, alterações de postura e marcha e incapacidade funcional com duração de duas semanas, em comparação com os escores quando da inclusão no estudo. Não foi observado efeito sobre o tremor. Em relação aos sintomas depressivos foi verificada melhora com duração de apenas uma semana. Estes resultados sugerem efeito benéfico da privação de sono na DP. Com base em estudos experimentais julgamos que uma explicação possível para estes resultados seja a modificação de receptores dopaminérgicos.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aknowledgements - We are grateful to medical students Ricardo Shiratsu and Rogério Tuma, who helped during sleep deprivation supervision and to Ms Masae Noguti, who typed the manuscript.

Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu, 740 - 04023 -São Paulo, SP - Brasil.

1. ANDRADE, L.A.F.; LIMA, J.G.C.; TUFIK, S.; BERTOLUCCI, P.H.F. & CARLINI, E.A. - REM sleep deprivation in an experimental model of Parkinson disease. Arq. Neuro-Psiquiat. (São Paulo) 45:217, 1987.
2. ASHCROFT, C.W.; CRAWFORD, T.B.B. & ECCLESTON, D. - 5-hydroxyndole compounds in the cerebrospinal fluid of patients with psychiatric or neurological disease. Lancet 2:1049, 1966.
3. BHANJI, S. & ROY, G.A. - The treatment of psychotic depression by sleep deprivation: a replication study. Brit. J. Psychiat. 127:222, 1975.
4. BUNNET, W.E.; BRODIE, H.K.H.; MURPHY, D.L. & GOODWIN, F.K. - Studies of alpha-methyl-para-tyrosine, L-Dopa and L-tryptophan in depression and mania. Amer. J. Psychiat. 127:48, 1971.
5. CARLINI, E.A. & LINDSEY, C.J. - Pharmacological manipulations of brain catecholamines and the aggressive behavior induced by marihuana in REM-sleep deprived rats. Agg. Behav. 1:81, 1974.
6. CARLINI, E.A.; LINDSEY, C.J. & TUFIK, S. - Environmental and drug interference with effects of marihuana. Ann. N.Y. Acad. Sci. 281:229, 1976.
7. COPPEN, A.; PRANGE, A.J.; WHYBROW, P.C. & NOGUEIRA, R. - Abnormalities of indoleamines in affective illness. Arch. gen. Psychiat. 26:474, 1972.
8. FERGUSON, J. & DEMENT, W. - The behavioral effects of amphetamine on REM deprived rats. J. psychiat. Res. 7:111, 1969.
9. HALARIS, A.E. & FREEDMAN, D.X. - Psychotropic drugs and dopamine uptake inhibition. Res. Publ. Assoc. nerv. ment. Dis. 54:248, 1975.
10. HAMILTON, M. - A rating scale for depression. J. Neurol. Neurosurg. Psychiat. 23:56, 1960.
11. HORNYKIEWICZ, O. - Brain neurotransmitter changes in Parkinson's disease. In C.D. Marsden & S. Fahn (eds.): Movement Disorders. Ed. 1. Butterworths, London, 1982. pg. 41.
12. KLERMAN, G.L.; SCHILDKRAUT, J.J.; HASENBUCH, L.L.; GREENBLATT, M. & FRIEND, D.G. - Clinical experience with dyhydrc-xyphenilalanine (DOPA) in depression. J. psychiat. Res. 1:289, 1963.
13. LARSEN, J.K.; LINDBERG, M.L. & SKOVGAARD, B. - Sleep deprivation as treatment for endogenous depression. Acta psychiat. scand. 54:167, 1976.
14. LESSER, R.P.; FAHN, S.; SNIDER, S.R.; COTE, L.J.; ISGREEN, W.P. & BARRET, R.E. - Analysis of the clinical problems in parkinsonism and the complications of long-term levodopa therapy. Neurology 29:1253, 1979.
15. LIEBERMAN, A.; DZIATOLOWSKI, M.; GOPINATHAN, G.; KUPERSMITH, M.; NEOPHYTIDES, A. & KOREIN, J. - Evaluation of Parkinson's disease. In M. Goldstein, D.B. Calne, A. Lieberman & M.O. Thomer ieds.): Ergot Compounds and Brain Function. Ed. 1. Raven Press, New York, 1980, pg. 277.
16. MOGILNICKA, E. - REM sleep deprivation changes behavioral response to catecholaminergic and serotonergic receptor activation in rats. Pharmac. biochem. Behav. 15:149, 1981.
17. PFLUG, B. - The effect of sleep deprivation on depressed patients. Acta psychiat. scand. 53:148, 1976.
18. POST, R.M.; KOTIN, J.; GOODWIN, F.K. & GORDON, E.K. - Psychomotor activity and cerebrospinal fluid amine metabolites in affective illness. Amer. J. Psychiat. 130:67, 1973.
19. RANDRUP, A. & BRAESTRUP, C. - Uptake inhibition of biogenic amines by newer antidepressant drugs: relevance to the hypothesis of depression. Psycho-pharmacology 53:309, 1977.
20. RINNE, U.K. - Brain neurotransmitter receptors in Parkinson's disease. In CD. Marsden & S. Fahn (eds.): Movement Disorders. Ed. 1. Butterworths, London, 1982. pg. 59.
21. TAKAHASHI, R.; NAGAO, Y.; TSUCHIYA, K.; TAKAMIZAWA, M.; KOBAYASHI, T.; TORU, M.; KOBAYASHI, K. & KARIYA, T. - Catecholamine metabolism of manic-depressive illness. J. psychiat. Res. 6:185, 1968.
22. TUFIK, S. - Changes of response to dopaminergic drugs in rats submitted to REM-sleep deprivation. Psychopharmacology 72:257, 1981.
23. TUFIK, S. - Increased responsiveness to apomorphine after REM sleep deprivation: supersensitivity of dopamine receptors or increase in dopamine turnover? J. Pharm. Pharmacol. 33:732, 1981.
24. TUFIK, S.; LINDSEY, C.J. & CARLINI, E.A. - Does REM sleep deprivation induce a supersensitivity of dopaminergic receptors in brain? Pharmacology 16:98, 1978.
25. TURNER, W.J. & MERLIS, S. - A clinical trial of pargyline and Dopa in psychotic subjects. Dis. nerv. System 25:38, 1964.
26. VOGEL, G.W.; TRAUB, A.C.; BEN-HORIN, P. & MEYERS, G.M. - REM sleep deprivation. II. The effects on depressed patients. Arch. gen. Psychiat. 18:301, 1968.
27. VOGEL, G.W.; THURMOND, A.; GIBBONS, P.; SDEAN, K.; BOYD, M. & WALKER. M. - REM sleep reduction effects on depression syndromes. Arch, gen. Psychiat. 32:765, 1975.
28. VOGEL, G.W.; VOGEL, F.; McABEE, R.S. & THURMOND, A.J. - Improvement of depression by REM sleep deprivation. Arch. gen. Psychiat. 37:247, 1980.

Datas de Publicação

Publicação nesta coleção
22 Jun 2011
Data do Fascículo
Set 1987

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANDRADE, L.A.F.; LIMA, J.G.C.; TUFIK, S.; BERTOLUCCI, P.H.F. & CARLINI, E.A. - REM sleep deprivation in an experimental model of Parkinson disease. Arq. Neuro-Psiquiat. (São Paulo) 45:217, 1987.

[2] 2. ASHCROFT, C.W.; CRAWFORD, T.B.B. & ECCLESTON, D. - 5-hydroxyndole compounds in the cerebrospinal fluid of patients with psychiatric or neurological disease. Lancet 2:1049, 1966.

[3] 3. BHANJI, S. & ROY, G.A. - The treatment of psychotic depression by sleep deprivation: a replication study. Brit. J. Psychiat. 127:222, 1975.

[4] 4. BUNNET, W.E.; BRODIE, H.K.H.; MURPHY, D.L. & GOODWIN, F.K. - Studies of alpha-methyl-para-tyrosine, L-Dopa and L-tryptophan in depression and mania. Amer. J. Psychiat. 127:48, 1971.

[5] 5. CARLINI, E.A. & LINDSEY, C.J. - Pharmacological manipulations of brain catecholamines and the aggressive behavior induced by marihuana in REM-sleep deprived rats. Agg. Behav. 1:81, 1974.

[6] 6. CARLINI, E.A.; LINDSEY, C.J. & TUFIK, S. - Environmental and drug interference with effects of marihuana. Ann. N.Y. Acad. Sci. 281:229, 1976.

[7] 7. COPPEN, A.; PRANGE, A.J.; WHYBROW, P.C. & NOGUEIRA, R. - Abnormalities of indoleamines in affective illness. Arch. gen. Psychiat. 26:474, 1972.

[8] 8. FERGUSON, J. & DEMENT, W. - The behavioral effects of amphetamine on REM deprived rats. J. psychiat. Res. 7:111, 1969.

[9] 9. HALARIS, A.E. & FREEDMAN, D.X. - Psychotropic drugs and dopamine uptake inhibition. Res. Publ. Assoc. nerv. ment. Dis. 54:248, 1975.

[10] 10. HAMILTON, M. - A rating scale for depression. J. Neurol. Neurosurg. Psychiat. 23:56, 1960.

[11] 11. HORNYKIEWICZ, O. - Brain neurotransmitter changes in Parkinson's disease. In C.D. Marsden & S. Fahn (eds.): Movement Disorders. Ed. 1. Butterworths, London, 1982. pg. 41.

[12] 12. KLERMAN, G.L.; SCHILDKRAUT, J.J.; HASENBUCH, L.L.; GREENBLATT, M. & FRIEND, D.G. - Clinical experience with dyhydrc-xyphenilalanine (DOPA) in depression. J. psychiat. Res. 1:289, 1963.

[13] 13. LARSEN, J.K.; LINDBERG, M.L. & SKOVGAARD, B. - Sleep deprivation as treatment for endogenous depression. Acta psychiat. scand. 54:167, 1976.

[14] 14. LESSER, R.P.; FAHN, S.; SNIDER, S.R.; COTE, L.J.; ISGREEN, W.P. & BARRET, R.E. - Analysis of the clinical problems in parkinsonism and the complications of long-term levodopa therapy. Neurology 29:1253, 1979.

[15] 15. LIEBERMAN, A.; DZIATOLOWSKI, M.; GOPINATHAN, G.; KUPERSMITH, M.; NEOPHYTIDES, A. & KOREIN, J. - Evaluation of Parkinson's disease. In M. Goldstein, D.B. Calne, A. Lieberman & M.O. Thomer ieds.): Ergot Compounds and Brain Function. Ed. 1. Raven Press, New York, 1980, pg. 277.

[16] 16. MOGILNICKA, E. - REM sleep deprivation changes behavioral response to catecholaminergic and serotonergic receptor activation in rats. Pharmac. biochem. Behav. 15:149, 1981.

[17] 17. PFLUG, B. - The effect of sleep deprivation on depressed patients. Acta psychiat. scand. 53:148, 1976.

[18] 18. POST, R.M.; KOTIN, J.; GOODWIN, F.K. & GORDON, E.K. - Psychomotor activity and cerebrospinal fluid amine metabolites in affective illness. Amer. J. Psychiat. 130:67, 1973.

[19] 19. RANDRUP, A. & BRAESTRUP, C. - Uptake inhibition of biogenic amines by newer antidepressant drugs: relevance to the hypothesis of depression. Psycho-pharmacology 53:309, 1977.

[20] 20. RINNE, U.K. - Brain neurotransmitter receptors in Parkinson's disease. In CD. Marsden & S. Fahn (eds.): Movement Disorders. Ed. 1. Butterworths, London, 1982. pg. 59.

[21] 21. TAKAHASHI, R.; NAGAO, Y.; TSUCHIYA, K.; TAKAMIZAWA, M.; KOBAYASHI, T.; TORU, M.; KOBAYASHI, K. & KARIYA, T. - Catecholamine metabolism of manic-depressive illness. J. psychiat. Res. 6:185, 1968.

[22] 22. TUFIK, S. - Changes of response to dopaminergic drugs in rats submitted to REM-sleep deprivation. Psychopharmacology 72:257, 1981.

[23] 23. TUFIK, S. - Increased responsiveness to apomorphine after REM sleep deprivation: supersensitivity of dopamine receptors or increase in dopamine turnover? J. Pharm. Pharmacol. 33:732, 1981.

[24] 24. TUFIK, S.; LINDSEY, C.J. & CARLINI, E.A. - Does REM sleep deprivation induce a supersensitivity of dopaminergic receptors in brain? Pharmacology 16:98, 1978.

[25] 25. TURNER, W.J. & MERLIS, S. - A clinical trial of pargyline and Dopa in psychotic subjects. Dis. nerv. System 25:38, 1964.

[26] 26. VOGEL, G.W.; TRAUB, A.C.; BEN-HORIN, P. & MEYERS, G.M. - REM sleep deprivation. II. The effects on depressed patients. Arch. gen. Psychiat. 18:301, 1968.

[27] 27. VOGEL, G.W.; THURMOND, A.; GIBBONS, P.; SDEAN, K.; BOYD, M. & WALKER. M. - REM sleep reduction effects on depression syndromes. Arch, gen. Psychiat. 32:765, 1975.

[28] 28. VOGEL, G.W.; VOGEL, F.; McABEE, R.S. & THURMOND, A.J. - Improvement of depression by REM sleep deprivation. Arch. gen. Psychiat. 37:247, 1980.