ML Fantini, JF Gagnon, D Filipini, J Montplaisir
Neurology 2003; 61:1418-1420.

Pramipexole reduces simple motor behaviors of REM sleep behavior disorder, according to this study.
Eight patients with RBD (mean symptom duration 8.3 years) received baseline polysomnography and then pramipexole (mean dosage 0.78 mg/day) at bedtime. Follow-up PSG occurred at a mean of 4.5 months.
Seven patients experienced a reduction in the frequency, intensity, or both, of self-reported RBD clinical manifestations, The effect lasted only two weeks for two patients, and was still present at six months in five patients. The mean number of REM sleep simple motor behaviors declined from 139 to 64 (p The authors state, “The clinical improvement observed with dopamine agonist treatment for patients with currently idiopathic RBD in the present study further supports the notion of a common pathophysiologic mechanism underlying [RBD and Parkinson’s disease].” In an accompanying editorial, Jean Matheson and Clifford Saper state, “it has become abundantly clear that RBD should be considered to represent a ‘preparkinsonian’ state.” Because treatment did not change periodic limb movements either during sleep or wakefulness, they suggest that the pathophysiology of PLMs may differ between patients with and without RBD.

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