Kayumov L, Zhdanova I V, Shapiro C M
Department of Psychiatry, Playfair Neuroscience Unit, the University of Toronto, Canada.
Semin Clin Neuropsychiatry. 2000 Jan;5(1):44-55. doi: 10.153/SCNP00500044.
In the 1970s and early 1980s, neuroendocrinology was viewed by many neuroscientists as a ""window to the brain" to an understanding of brain function." In psychiatry, many have viewed sleep physiology as a window in biological psychiatry. This is, in part, because sleep is one of the few easily quantifiable functions of interest to psychiatrists. Melatonin is a hormone with powerful effects on behavior particularly circadian and sleep behavior. In contrast with other hormones, the pathophysiology and pathology of abnormal melatonin secretion is poorly understood. In this article, we document the well-established phase-shifting and sleep-promoting effects of melatonin and discuss some implications for neuropsychiatrists when the neurophysiology of melatonin goes array. It is both striking and in some ways not surprising that the majority of patients with phase delay syndrome described in our research studies have been misdiagnosed as having depression. The reason for this is elucidated in this article and the information concerning this condition may be helpful to many who are relatively unfamiliar with this particular sleep disorder. We can anticipate that patients with specific neurological disorders may have changes in their melatonin secretion and future research, for example in patients with head injury and conditions such as retinitis pigmentosa may be the basis for reviews a few years hence.
在20世纪70年代和80年代初，神经内分泌学被许多神经科学家视为理解脑功能的“大脑之窗”。在精神病学领域，许多人将睡眠生理学视为生物精神病学的一扇窗口。部分原因在于，睡眠是精神病学家感兴趣的少数几种易于量化的功能之一。褪黑素是一种对行为尤其是昼夜节律和睡眠行为有强大影响的激素。与其他激素相比，褪黑素分泌异常的病理生理学和病理学知之甚少。在本文中，我们记录了褪黑素已被充分证实的相位转移和促进睡眠的作用，并讨论了当褪黑素神经生理学紊乱时对神经精神科医生的一些启示。在我们的研究中描述的大多数相位延迟综合征患者被误诊为患有抑郁症，这既令人惊讶又在某种程度上不足为奇。本文对此原因进行了阐释，有关这种情况的信息可能对许多相对不熟悉这种特殊睡眠障碍的人有所帮助。我们可以预期，患有特定神经系统疾病的患者可能会出现褪黑素分泌变化，未来的研究，例如对头部受伤患者和视网膜色素变性等疾病的研究，可能会成为几年后综述的基础。
