Caffeine for treatment of Parkinson disease: a randomized controlled trial
Postuma RB, Lang AE, Munhoz RP, Charland K, Pelletier A, Moscovich M, Filla L, Zanatta D, Rios Romenets S, Altman R, Chuang R, Shah B
Neurology · 203 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Canadian Institutes of Health Research
Según 1 financiador declarado.
Publicación
- Publicado
- 2012-08-02 · Neurology · vol. 79 · número 7 · págs. 651–658
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 298 citas · más que el 99% de estudios similares · 11.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 41 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Parkinson's Disease Mechanisms and Treatments · Coffee research and impacts · Neurological disorders and treatments
- Palabras clave
- caffeine, Parkinson's disease, excessive daytime sleepiness, adenosine receptor antagonism, motor impairment severity, non-motor symptoms, fatigue, depression, quality of life, sleep quality
- MeSH
- humans, parkinson disease, fatigue, caffeine, central nervous system stimulants, treatment outcome, severity of illness index, quality of life, aged, aged, 80 and over, middle aged, female, male
12 autores
- Ronald B. Postuma🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Anthony E. Lang🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Renato P. Munhoz🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Katia Charland🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Amélie Pelletier🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Mariana Moscovich🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Luciane Filla🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Débora Zanatta🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Silvia Ríos Romenets🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Robert Altman🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Rosa Chuang🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
- Binit Shah🇧🇷🇨🇦Pontifícia Universidade Católica do Paraná; University of Toronto; Toronto Western Hospital; Montreal General Hospital; McGill University Health Centre; Research Institute of the McGill University Health Centre; McGill University
Resumen
El texto original del estudio, en el idioma en que se publicó.
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.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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