Prolonged Dietary Restriction and Its Effects on Dopamine Systems of the Brain

Scalzo, Frank M.

doi:10.1007/978-1-4615-3326-9_2

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“…Subjects bearing this kind of lesion exhibit several sequelae such as decreased motor activity, muscle atrophy, reduction and impairment of metabolic and cardiac activity, as well as the decline of physical capacity. 23 In spinal cord injured (at the level of T7 ± T12) subjects, abnormal lower limb movements (PLM) could be in¯uenced by dopamine at the spinal level. 24,25 Consequently, the dopaminergic inhibitory role on abnormal motor activity is impaired by the spinal cord lesion, and might be restored by treatment with L-dopa associated with benzerazide as suggested by the above results.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of periodic leg movements with a dopaminergic agonist in subjects with total spinal cord lesions

1999

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Objective: To investigate the eect of L-dopa on the PLM/h index of spinal cord injured subjects. Setting: SaÄ o Paulo, Brazil. Methods: Thirteen male volunteers with spinal cord section between T7 ± T12, and mean age of 31.6+8.3 years participated in the study. L-dopa or placebo were administered for 30 days, 1 h before the volunteers went to sleep, in a double blind, crossover design. Polysomnographic recordings were performed on ten occasions: Phase 1: Basal night, following an adaptation night at the sleep laboratory; phase 2: after 1, 7, 21 and 30 days of L-dopa administration; phase 3: ®rst night of L-dopa or placebo withdrawal; phase IV: 1, 7, 21 and 30 days after placebo ingestion. Results: The index of PLM/h on the ®rst night of L-dopa or placebo withdrawal (phase III) was lower than on both the basal night and the ®rst night of L-dopa treatment. At the time of polysomnographic analysis, volunteers were divided into two groups: index of PLM/h below ®ve and those whose index was above ®ve. Comparison between L-dopa and placebo treatments revealed that only those volunteers with an index above ®ve revealed a reduction in PLM in L-dopa. Conclusion: These results indicate that despite the spinal cord lesions, L-dopa treatment is capable of minimizing PLM during sleep.Keywords: sleep; spinal cord lesion(s); L-dopa; periodic leg movements (PLM); paraplegic; restless legs syndrome (RLS) IntroductionThe restless legs syndrome (RLS) was originally described in the general population by Ekbom. There is, however, a lack of consensus regarding dosage and length of administration of these drugs with therapeutic doses ranging between 100 and 250 mg of L-dopa.Recently, a high incidence of PLM and RLS in subjects with spinal cord lesions have been reported, 8 ± 12 allowing the possibility of identifying the origin of these abnormal movements. These subjects spontaneously report sleep problems, and also even mention the need to be tied to the bed so as to avoid falling on the¯oor due to the frequency of lower limb movements during sleep.9 Moreover, reduction of the incidence of PLM and RLS following acute physical activity in these patients may be helpful for the identi®cation of the mechanisms underlying PLM and RLS.10,13 Thus, it is possible that the reduction of limb movements may stem from endorphin secretion induced by physical activity, 14 since treatment with opiates often results in a reduction of PLM and RLS.3 In addition, there is an important positive correlation between PLM and K complexes in spinal cord injured 10,11 and non-paraplegic subjects. 3 To our knowledge, there is no study of PLM in spinal cord lesioned subjects treated with dopaminergic agonists.It is known that dopamine plays an important role in motor activity in general. Demonstrably, dopaminergic agonists induce a decrease in motor activity. Spinal Cord (1999) 37, 634 ± 637 ã 1999 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/99 $15.00http://www.stockton-press.co.uk/sc abnormal movements in Parkinsonian patients....

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Section: Discussionmentioning

confidence: 99%

“…22 Volunteers followed a speci®ed dietary regime on the lines recommended for the entire duration of the study. 23 …”

Section: Methodsmentioning

confidence: 99%