ParkinsonCanadaV1, Main, Exploration, bibRecord, 001547

Caffeine for treatment of Parkinson disease: A randomized controlled trial

Identifieur interne : 001547 ( Main/Exploration ); précédent : 001546; suivant : 001548

Caffeine for treatment of Parkinson disease: A randomized controlled trial

Auteurs : Ronald B. Postuma [Canada] ; Anthony E. Lang [Canada] ; Renato P. Munhoz [Brésil] ; Katia Charland [Canada] ; Amelie Pelletier [Canada] ; Mariana Moscovich [Brésil] ; Luciane Filla [Brésil] ; Debora Zanatta [Brésil] ; Silvia Rios Romenets [Canada] ; Robert Altman [Canada] ; Rosa Chuang [Canada] ; Binit Shah [Canada]

Source :

Neurology [ 0028-3878 ] ; 2012.

RBID : Pascal:12-0344919

Descripteurs français

Pascal (Inist)
- Maladie de Parkinson, Pathologie du système nerveux, Caféine, Traitement.

English descriptors

KwdEn :
- Aged, Aged, 80 and over, Caffeine, Caffeine (therapeutic use), Central Nervous System Stimulants (therapeutic use), Fatigue (drug therapy), Female, Humans, Male, Middle Aged, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson disease, Quality of Life, Severity of Illness Index, Treatment, Treatment Outcome.
MESH :
- chemical , therapeutic use : Caffeine, Central Nervous System Stimulants.
- drug therapy : Fatigue, Parkinson Disease.
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Quality of Life, Severity of Illness Index, Treatment Outcome.

Abstract

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 x3 weeks, then 200 mg twice daily x3 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.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414662

Affiliations:

Le document en format XML

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</author>
</analytic>
<series><title level="j" type="main">Neurology</title>
<title level="j" type="abbreviated">Neurology</title>
<idno type="ISSN">0028-3878</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Neurology</title>
<title level="j" type="abbreviated">Neurology</title>
<idno type="ISSN">0028-3878</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Caffeine</term>
<term>Caffeine (therapeutic use)</term>
<term>Central Nervous System Stimulants (therapeutic use)</term>
<term>Fatigue (drug therapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Nervous system diseases</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson disease</term>
<term>Quality of Life</term>
<term>Severity of Illness Index</term>
<term>Treatment</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Caffeine</term>
<term>Central Nervous System Stimulants</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Fatigue</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Quality of Life</term>
<term>Severity of Illness Index</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term>
<term>Pathologie du   système nerveux</term>
<term>Caféine</term>
<term>Traitement</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">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 x3 weeks, then 200 mg twice daily x3 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.</div>
</front>
</TEI>
<affiliations><list><country><li>Brésil</li>
<li>Canada</li>
</country>
<region><li>Ontario</li>
<li>Québec</li>
</region>
<settlement><li>Montréal</li>
<li>Toronto</li>
</settlement>
<orgName><li>Université McGill</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="Canada"><region name="Québec"><name sortKey="Postuma, Ronald B" sort="Postuma, Ronald B" uniqKey="Postuma R" first="Ronald B." last="Postuma">Ronald B. Postuma</name>
</region>
<name sortKey="Altman, Robert" sort="Altman, Robert" uniqKey="Altman R" first="Robert" last="Altman">Robert Altman</name>
<name sortKey="Charland, Katia" sort="Charland, Katia" uniqKey="Charland K" first="Katia" last="Charland">Katia Charland</name>
<name sortKey="Chuang, Rosa" sort="Chuang, Rosa" uniqKey="Chuang R" first="Rosa" last="Chuang">Rosa Chuang</name>
<name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name>
<name sortKey="Pelletier, Amelie" sort="Pelletier, Amelie" uniqKey="Pelletier A" first="Amelie" last="Pelletier">Amelie Pelletier</name>
<name sortKey="Pelletier, Amelie" sort="Pelletier, Amelie" uniqKey="Pelletier A" first="Amelie" last="Pelletier">Amelie Pelletier</name>
<name sortKey="Rios Romenets, Silvia" sort="Rios Romenets, Silvia" uniqKey="Rios Romenets S" first="Silvia" last="Rios Romenets">Silvia Rios Romenets</name>
<name sortKey="Shah, Binit" sort="Shah, Binit" uniqKey="Shah B" first="Binit" last="Shah">Binit Shah</name>
</country>
<country name="Brésil"><noRegion><name sortKey="Munhoz, Renato P" sort="Munhoz, Renato P" uniqKey="Munhoz R" first="Renato P." last="Munhoz">Renato P. Munhoz</name>
</noRegion>
<name sortKey="Filla, Luciane" sort="Filla, Luciane" uniqKey="Filla L" first="Luciane" last="Filla">Luciane Filla</name>
<name sortKey="Moscovich, Mariana" sort="Moscovich, Mariana" uniqKey="Moscovich M" first="Mariana" last="Moscovich">Mariana Moscovich</name>
<name sortKey="Zanatta, Debora" sort="Zanatta, Debora" uniqKey="Zanatta D" first="Debora" last="Zanatta">Debora Zanatta</name>
</country>
</tree>
</affiliations>
</record>

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La maladie de Parkinson au Canada (serveur d'exploration)

Caffeine for treatment of Parkinson disease: A randomized controlled trial

Caffeine for treatment of Parkinson disease: A randomized controlled trial

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	La maladie de Parkinson au Canada (serveur d'exploration)
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