Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France.
Int J Mol Sci. 2013 Oct 14;14(10):20508-42. doi: 10.3390/ijms141020508.
Abnormalities in melatonin physiology may be involved or closely linked to the pathophysiology and behavioral expression of autistic disorder, given its role in neurodevelopment and reports of sleep-wake rhythm disturbances, decreased nocturnal melatonin production, and beneficial therapeutic effects of melatonin in individuals with autism. In addition, melatonin, as a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. More specifically, the role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of peripheral oscillators opens interesting perspectives to ascertain better the mechanisms underlying the significant relationship found between lower nocturnal melatonin excretion and increased severity of autistic social communication impairments, especially for verbal communication and social imitative play. In this article, first we review the studies on melatonin levels and the treatment studies of melatonin in autistic disorder. Then, we discuss the relationships between melatonin and autistic behavioral impairments with regard to social communication (verbal and non-verbal communication, social interaction), and repetitive behaviors or interests with difficulties adapting to change. In conclusion, we emphasize that randomized clinical trials in autism spectrum disorders are warranted to establish potential therapeutic efficacy of melatonin for social communication impairments and stereotyped behaviors or interests.
鉴于褪黑素在神经发育中的作用以及其与睡眠-觉醒节律紊乱、夜间褪黑素生成减少的相关性报告，还有褪黑素对自闭症个体的有益治疗作用，其生理学异常可能与自闭症的病理生理学和行为表现有关或密切相关。此外，褪黑素作为一种由血清素产生的松果腺激素，在自闭症中特别引人关注，因为有报道称中枢和外周血清素神经生物学发生了改变。更具体地说，褪黑素在昼夜节律的发生和外周振荡器的同步中的作用为确定昼夜褪黑素排泄减少与自闭症社会交流障碍严重程度增加之间的显著关系的潜在机制提供了有趣的视角，尤其是对于言语交流和社会模仿游戏。在本文中，我们首先回顾了褪黑素水平的研究和褪黑素治疗自闭症的研究。然后，我们讨论了褪黑素与自闭症行为障碍之间的关系，包括社会交流（言语和非言语交流、社会互动）和刻板行为或兴趣以及难以适应变化的问题。总之，我们强调有必要在自闭症谱系障碍中进行随机临床试验，以确定褪黑素治疗社会交流障碍和刻板行为或兴趣的潜在疗效。
