Journal des troubles du sommeil : traitement et soins

Rotigotine Improve ThoracoAbdominal Movement in Elderly Patients with Vascular Parkinsonism Post-Stroke: A Statistical Observation about the Reduction of the Obstructive Sleep Apnoea Syndrome Index

Marchitto N, Sindona F, Fabrizio A, Visani N, Dalmaso S and Raimondi G

Parkinsons disease and Vascular Parkinsonism are a frequent an underestimated disease in diseased people that play an important role in quality of life. They can be due to ischemic stroke in the area of the basal ganglia in patients with cardiovascular risk factors or brain lesions of the periventricular white substance. This disease reduces the motor symptoms, often causing diffused tremor (i.e. head, arms and legs) due to reduce level of endogenous dopamine. Also, in frailty patients there is a high incidence of breath and sleep disorder. Sleep respiratory disorders are one of the most frequent conditions in elderly patients with frailty, but often understimated. Respiratory disorders are distinguished in 3 items: peripheral, central and mixed. This classification is based on polisomnographic test. In a frailty patient’s group we have used this method to asses the possible correlation between ischemic stroke and correlated dopaminergic deficit that determines a complications of motor symptoms (extra-pyramidal syndrome and bradikinesia) and a worsening of the obstructive sleep apnoea syndrome (OSAS). We have enrolled 30 patients (13 male and 17 female with range age 60–92 years) who underwent polysomnografic test measuring thoraco-abdominal movement before and after a continuous and constant dopaminergic therapy in 24 hours. Analogly we have evaluated the oxygen saturation and the number of OSAS events/hour. Some data in licterature report that the reduction of the dopaminergic level can determinated muscular dyssynchrony that worsens respiratory activity and osas. Our data show that continuous and constant dopaminergic stimulation through Rotigotine transdermal patch improves thoraco-abdominal movements and therefore the OSAS index. Our data give comfortable results but further investigation is needed to have conclusive results.