Novel Therapeutic Approach for Parkinson Disease during REM Sleep

Miguel Angel Pieroni and Pa

Abstract

Study objectives: The physiological responses of an individual depend on preset limits. They must be able to adapt it to changing environmental conditions, modifying the thresholds. We propose a regulatory function of biological responses during REM sleep. Responses previously developed during wakefulness, are evaluated and regulated for integration into the repertoire of responses during sleep. The aims of this study were to evaluate the impact of the restoration of REM sleep in patients with Parkinson disease by stimulation of D2 receptors and to evaluate the symptomatic benefit of this approach. Methods: Ten parkinsonian patients underwent a polysomnography study using nocturnal apomorphine subcutaneous administration at the beginning of each REM detected along all night recording. Results: This therapeutic approach led to a significant benefit for patients in all of three UPDRS scores. The mean UPDRS III motor examination “On” scores (mean ± SD) were reduced by 9.4 ± 8.5 points (p<0.0001). For patients in the UPDRS II scores a total difference of 12 ± 4.22 to 5.2 ± 5.22 (p<0.0001) were observed; and in total UPDRS I the difference was of 5.2 points (p<0.0001), with a reduction from 8.4 ± 3.2 to 3.2 ± 3.1. Conclusion: Sleep alteration can be improved by stimulation of D2 receptors. The symptomatic benefits obtained linked to the restoration of REM functions in patients with PD were significant.