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.


METHODS
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.
University Clinics of Schleswig-Holstein, Campus Kiel, Department of Pediatrics, Kiel, Germany.
Sebastian
S
Schulz-Juergensen
Mareike
M
Rieger
Judith
J
Schaefer
Andrea
A
Neusuess
Paul
P
Eggert
D000161:Acoustic Stimulation; D002648:Child; D018592:Cross-Over Studies; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D009433:Neural Inhibition / Q000187:drug effects*; D053206:Nocturnal Enuresis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D013216:Reflex, Startle / Q000187:drug effects* / Q000502:physiology
D003894:Deamino Arginine Vasopressin