Effects of melatonin prolonged-release on both sleep and motor symptoms in Parkinson's disease: a preliminary evidence.


Journal

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 07 01 2022
accepted: 29 04 2022
pubmed: 11 5 2022
medline: 20 8 2022
entrez: 10 5 2022
Statut: ppublish

Résumé

Sleep-related symptoms, especially insomnia, are frequently reported by patients with Parkinson's disease (PD) and can markedly affect motor symptoms and impair patients' quality of life. Melatonin has been shown to improve sleep in PD patients. This pilot study aimed at evaluating the effects of a 3-month treatment with 2 mg melatonin prolonged-release (PR) on sleep and motor disability in PD patients. Twelve PD patients under stable antiparkinsonian treatment were enrolled in the study. Before treatment (T0), motor dysfunction was assessed with Unified Parkinson's Disease Rating Scale (UPDRS-III) and sleep architecture with polysomnography. Subjective sleep quality was also assessed through Pittsburgh Sleep Quality Index (PSQI) and daytime somnolence with Epworth Sleepiness Scale (ESS). Patients then started melatonin PR and all measures were repeated at the end of treatment after 3 months (T1). Sleep latency significantly decreased from T0 to T1, but no other significant differences were found in PSG parameters. Melatonin PR treatment significantly reduced the ESS scores from T0 to T1, while the PSQI scores presented a trend of improvement from T0 to T1. Motor dysfunction was not improved by melatonin PR, although there was a trend in decreasing UPDRS-III. Both clinical global improvement and patient clinical global impression documented an improvement in insomnia symptoms at T1. These findings suggest that melatonin may improve sleep symptoms in PD patients, although further evidence is needed in larger controlled studies to confirm these results and explore the possible direct and indirect influence of sleep improvement on motor dysfunction.

Sections du résumé

BACKGROUND BACKGROUND
Sleep-related symptoms, especially insomnia, are frequently reported by patients with Parkinson's disease (PD) and can markedly affect motor symptoms and impair patients' quality of life. Melatonin has been shown to improve sleep in PD patients. This pilot study aimed at evaluating the effects of a 3-month treatment with 2 mg melatonin prolonged-release (PR) on sleep and motor disability in PD patients.
MATERIALS AND METHODS METHODS
Twelve PD patients under stable antiparkinsonian treatment were enrolled in the study. Before treatment (T0), motor dysfunction was assessed with Unified Parkinson's Disease Rating Scale (UPDRS-III) and sleep architecture with polysomnography. Subjective sleep quality was also assessed through Pittsburgh Sleep Quality Index (PSQI) and daytime somnolence with Epworth Sleepiness Scale (ESS). Patients then started melatonin PR and all measures were repeated at the end of treatment after 3 months (T1).
RESULTS RESULTS
Sleep latency significantly decreased from T0 to T1, but no other significant differences were found in PSG parameters. Melatonin PR treatment significantly reduced the ESS scores from T0 to T1, while the PSQI scores presented a trend of improvement from T0 to T1. Motor dysfunction was not improved by melatonin PR, although there was a trend in decreasing UPDRS-III. Both clinical global improvement and patient clinical global impression documented an improvement in insomnia symptoms at T1.
CONCLUSIONS CONCLUSIONS
These findings suggest that melatonin may improve sleep symptoms in PD patients, although further evidence is needed in larger controlled studies to confirm these results and explore the possible direct and indirect influence of sleep improvement on motor dysfunction.

Identifiants

pubmed: 35536495
doi: 10.1007/s10072-022-06111-x
pii: 10.1007/s10072-022-06111-x
pmc: PMC9385777
doi:

Substances chimiques

Melatonin JL5DK93RCL

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

5355-5362

Informations de copyright

© 2022. The Author(s).

Références

J Neurol. 2007 Apr;254(4):459-64
pubmed: 17404779
Mov Disord. 2010 Nov 15;25(15):2649-53
pubmed: 21069833
J Pineal Res. 2015 Apr;58(3):262-74
pubmed: 25626558
Metab Brain Dis. 2013 Dec;28(4):705-9
pubmed: 23703110
Sleep Med. 2021 May;81:307-311
pubmed: 33756280
Mov Disord Clin Pract. 2018 Nov 08;6(1):57-64
pubmed: 30746417
Mov Disord. 2019 Feb;34(2):180-198
pubmed: 30653247
Brain Behav. 2021 Oct;11(10):e2336
pubmed: 34478245
Sleep. 1991 Dec;14(6):540-5
pubmed: 1798888
Neurol Sci. 2003 Feb;23(6):295-300
pubmed: 12624716
Parkinsonism Relat Disord. 2013 Jul;19(7):670-5
pubmed: 23561946
Clin Neurol Neurosurg. 2020 Aug;195:105878
pubmed: 32417629
J Parkinsons Dis. 2021;11(3):971-992
pubmed: 33896849
Mov Disord. 2011 Jan;26(1):90-9
pubmed: 21322021
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
Mov Disord. 2011 Mar;26(4):644-52
pubmed: 21312275
Neurology. 1967 May;17(5):427-42
pubmed: 6067254
Neurology. 2017 Jan 24;88(4):352-358
pubmed: 27986876
J Clin Sleep Med. 2012 Oct 15;8(5):597-619
pubmed: 23066376
PLoS One. 2017 Aug 11;12(8):e0183090
pubmed: 28800639
Sleep Med Rev. 2017 Oct;35:33-50
pubmed: 27863901
Parkinsonism Relat Disord. 2020 Jun;75:50-54
pubmed: 32480307
Mov Disord. 2010 Aug 15;25(11):1708-14
pubmed: 20589875
Sleep Med. 2003 Jul;4(4):339-42
pubmed: 14592307
Neurol Sci. 2013 Apr;34(4):511-9
pubmed: 22526760
Sleep Med. 2016 May;21:140-4
pubmed: 27448485
Mov Disord. 2015 Oct;30(12):1591-601
pubmed: 26474316
JAMA Neurol. 2018 Aug 1;75(8):1008-1012
pubmed: 29710120
Psychiatry (Edgmont). 2007 Jul;4(7):28-37
pubmed: 20526405
J Geriatr Psychiatry Neurol. 2021 Nov;34(6):642-658
pubmed: 33043810
Life Sci. 2018 Jan 1;192:238-245
pubmed: 29138117
J Sleep Res. 2007 Mar;16(1):102-9
pubmed: 17309769
Sleep Med. 2005 Sep;6(5):459-66
pubmed: 16084125
Cell Mol Neurobiol. 2020 Jan;40(1):15-23
pubmed: 31388798
Brain Sci. 2021 Feb 13;11(2):
pubmed: 33668408
J Neural Transm Suppl. 2006;(70):349-55
pubmed: 17017552
J Pineal Res. 2008 Mar;44(2):205-13
pubmed: 18289173
Neurology. 1998 May;50(5):1332-9
pubmed: 9595983
Curr Neurol Neurosci Rep. 2015 Mar;15(3):8
pubmed: 25687697
Front Psychiatry. 2021 Jun 10;12:688890
pubmed: 34177671
J Neurol. 2019 Mar;266(3):636-641
pubmed: 30607535
Lancet Neurol. 2018 Jun;17(6):559-568
pubmed: 29699914
Ther Clin Risk Manag. 2011;7:301-11
pubmed: 21845053
Neurol Sci. 2016 Feb;37(2):283-8
pubmed: 26520846
JAMA Neurol. 2014 Apr;71(4):463-9
pubmed: 24566763
Parkinsonism Relat Disord. 2013 Jul;19(7):654-9
pubmed: 23615667

Auteurs

Claudio Liguori (C)

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. dott.claudioliguori@yahoo.it.
Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. dott.claudioliguori@yahoo.it.
UOSD Parkinson's Disease, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. dott.claudioliguori@yahoo.it.

Mariana Fernandes (M)

Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Rocco Cerroni (R)

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
UOSD Parkinson's Disease, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Raffaella Ludovisi (R)

Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Nicola Biagio Mercuri (NB)

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
IRCCS Santa Lucia Foundation, Rome, Italy.

Alessandro Stefani (A)

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
UOSD Parkinson's Disease, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Mariangela Pierantozzi (M)

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
UOSD Parkinson's Disease, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH