کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3178137 1200330 2007 18 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Endogenous melatonin predicts efficacy of exogenous melatonin in consolidation of fragmented wrist-activity rhythm of adult patients with developmental brain disorders: A double-blind, placebo-controlled, crossover study
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
پیش نمایش صفحه اول مقاله
Endogenous melatonin predicts efficacy of exogenous melatonin in consolidation of fragmented wrist-activity rhythm of adult patients with developmental brain disorders: A double-blind, placebo-controlled, crossover study
چکیده انگلیسی

Objective:We studied whether the endogenous melatonin patterns in adult patients with developmental brain disorders have any role in response to exogenous melatonin given as a sleep-promoting medicine.Methods:Participants included 15 adults (18–60 years, five females) with developmental brain disorders of varying etiologies, motor handicaps, and long-term history of sleep problems. According to the 24-h patterns of serum melatonin, patients were divided into two subgroups: lower and higher secretors. The pretreatment sleep disorder was characterized by a structured interview, 24-h ambulatory polysomnography and 7-day wrist actigraphy. Patients received 1, 3, or 6 mg fast-release melatonin tablets, each for 4 weeks in increasing order, at a constant time of 30 min before the desired sleep onset. Similarly, placebos with different codes were given during 3 × 4 weeks. The 7-day actigraphy was repeated at the end of each drug period. Outcome measures were six different parameters of non-parametric circadian rhythm analysis. Drug effects and 40 confounding/modulating factors were evaluated by applying two-level regression analyses with co-variables.Results:Exogenous melatonin decreased the fragmentation of the rest–activity rhythm, increased the day/night ratio of activity and advanced the onset of rest period. The effects on fragmentation and day/night ratio were more pronounced in the lower than higher secretors of melatonin. Other contributing factors in the drug effects were blindness and some features of the original sleep disorder (disrupted cyclicity of the sleep architecture in polysomnography or reported daytime somnolence).Conclusions:Exogenous melatonin consolidated the fragmented rest–activity in about half of the patients. Low endogenous serum melatonin levels at night predicted improvement by the drug. Higher doses were not more effective than the lowest dose.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Sleep Medicine - Volume 8, Issue 3, April 2007, Pages 222–239
نویسندگان
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