Effect of 1-Desamino-8-D-Arginine Vasopressin on Prepulse Inhibition of Startle Supports a Central Etiology of Primary Monosymptomatic Enuresis
Objective
To test the hypothesis that 1-desamino-8-D-arginine vasopressin (dDAVP) has an effect on prepulse inhibition (PPI) of startle in patients with primary monosymptomatic enuresis (PME), thus indicating a central effect.
Study design
Patients with PME (n = 21, age 6 to 12 years) were enrolled in a prospective, randomized, double-blinded, cross-over study. Startle reflexes and PPI were measured under dDAVP treatment versus placebo.
Results
The data show that dDAVP has a significant effect on PPI, raising it from 38.88% under placebo to the age-related normal level of 62.6% with dDAVP treatment (P = .0127).
Conclusions
Our findings revive the concept of a central pathophysiology of PME and offer a different explanation for the effects of dDAVP, which not only acts on the kidney, but also is (as is AVP) a central neurotransmitter with a signal cascade on relevant reflex mechanisms.
Abbreviations: AVP, Arginine vasopressin, CI, Confidence interval, dDAVP, 1-desamino-8-D-arginine vasopressin, EMG, Electromyography, PME, Primary monosymptomatic enuresis, PPI, Prepulse inhibition, SPL, Sound pressure level, SS, Startle stimulus
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The authors have no financial or other conflicts of interest to declare. There was no external funding source; the study was supported by research funds from their university.
PII: S0022-3476(07)00489-1
doi:10.1016/j.jpeds.2007.05.024
© 2007 Mosby, Inc. All rights reserved.
Refers to article:
- Is Lack of Bladder Inhibition during Sleep a Mechanism of Nocturnal Enuresis?
- Urine Output Rate and Maximum Volume Voided in School-Age Children with and without Nocturnal Enuresis , 08 October 2007
