Motta Ewa, Czuczwar Stanisław J, Ostrowska Zofia, Gołba Anna, Sołtyk Jacek, Norman Radosław, Woźnik Gabriela
Department of Neurology, Silesian Medical University, Katowice, Poland.
Department of Pathophysiology, Medical University, Lublin, Poland; Department of Physiopathology, Institute of Agricultural Medicine, Lublin, Poland.
Pharmacol Rep. 2014 Jun;66(3):492-8. doi: 10.1016/j.pharep.2013.10.006. Epub 2014 Apr 13.
The results of a few previous studies assessing melatonin concentration in epileptic patient are ambiguous. This study aimed at: (1) comparing the circadian profile of salivary melatonin excretion in epileptic patients with that in healthy subjects and with circadian frequency profile of seizures and (2) assessing the effect of epileptic seizure upon salivary melatonin concentration.
The study included thirty patients suffering from drug-resistant epilepsy aged from 22 to 45 years (mean age 37.17, SD ± 10.25). All subjects had their saliva taken in order to determine melatonin concentration and its circadian excretion profile performed every 4h. Additionally, saliva samples were collected in order to assess concentration of melatonin directly after epileptic seizure and 2h later.
The circadian profile of melatonin secretion in epileptic patients did not differ significantly from a profile in healthy subjects. Epileptic women showed statistically higher average salivary melatonin concentration at 2a.m., 6a.m. and 10a.m., compared to epileptic men; this may be related to lower age average of women as well as to their different hormonal profile.
The significantly higher salivary melatonin concentration at 6a.m. in patients with diurnal seizures (occurring mainly in the morning) may suggest proconvulsive effect of this hormone. Epileptic seizure did not lead to significantly elevated salivary melatonin concentration. Epileptogenic effect of melatonin might be corroborated by significantly elevated salivary melatonin levels directly after nocturnal tonic-clonic seizure which affected patients with highest concentration of this hormone at 2a.m. These observations would need confirmation based on studies of larger groups of epileptic patients.
先前一些评估癫痫患者褪黑素浓度的研究结果并不明确。本研究旨在：（1）比较癫痫患者唾液褪黑素排泄的昼夜节律与健康受试者的昼夜节律以及癫痫发作的昼夜频率分布；（2）评估癫痫发作对唾液褪黑素浓度的影响。
该研究纳入了30例年龄在22至45岁（平均年龄37.17岁，标准差±10.25）的耐药性癫痫患者。所有受试者均采集唾液以测定褪黑素浓度，并每4小时进行一次昼夜排泄情况分析。此外，在癫痫发作后及发作2小时后采集唾液样本，以评估褪黑素浓度。
癫痫患者褪黑素分泌的昼夜节律与健康受试者相比无显著差异。与癫痫男性患者相比，癫痫女性患者在凌晨2点、6点和10点时唾液褪黑素平均浓度在统计学上更高；这可能与女性较低的平均年龄及其不同的激素水平有关。
日间发作（主要发生在早晨）的患者在上午6点时唾液褪黑素浓度显著升高，这可能提示该激素具有促惊厥作用。癫痫发作并未导致唾液褪黑素浓度显著升高。夜间强直阵挛发作后唾液褪黑素水平显著升高，这可能证实了褪黑素的致癫痫作用，而这些患者在凌晨2点时该激素浓度最高。这些观察结果需要基于对更大规模癫痫患者群体的研究来加以证实。
