Cruz-Aguilar Manuel Alejandro, Ramírez-Salado Ignacio, Hernández-González Marisela, Guevara Miguel Angel, Rivera-García Ana Paula
Laboratorio de Cronobiología y Sueño, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz,"Ciudad de México, CDMX, México.
Laboratorio de Neurofisiología de la Conducta Reproductiva, Instituto de Neurociencias, CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, México.
Int J Neurosci. 2023 Apr;133(4):441-449. doi: 10.1080/00207454.2021.1928115. Epub 2021 Jun 1.
It has been reported that melatonin diminishes rapid eye movement (REM) sleep latency in patients with Alzheimer's disease (AD). Pharmacological studies suggest that melatonin promotes prompt sleep installation through interaction with GABA receptors, and that it is associated with acute suppression of neural electrical activity. Nevertheless, melatonin's effects on electroencephalographic (EEG) activity related to REM sleep onset in AD patients have not been analyzed. Thus, in this pilot study we analyzed the effects of melatonin on EEG activity during the first episode of REM sleep in eight patients treated with 5-mg of fast-release melatonin. During a single-blind, placebo-controlled study, polysomnographic recordings were obtained from frontal, central, temporal, and occipital scalp derivations. REM sleep latency, as well as the relative power (RP) and EEG coherences of six EEG bands, were compared between the placebo and melatonin conditions. Results showed that melatonin intake in AD patients decreased REM sleep onset, and that this was associated with lower RP and coherence of the β and γ EEG bands. The possibility that the inhibitory GABAergic pathways related to REM sleep generation are well-preserved in mild-to-moderate AD is discussed. We conclude that the short REM sleep onset related to melatonin intake in AD patients is associated with a significant decrease in both RP and EEG coherence, mainly in the fast frequencies.
据报道，褪黑素可缩短阿尔茨海默病（AD）患者的快速眼动（REM）睡眠潜伏期。药理学研究表明，褪黑素通过与γ-氨基丁酸（GABA）受体相互作用促进快速入睡，且与神经电活动的急性抑制有关。然而，褪黑素对AD患者REM睡眠起始相关脑电图（EEG）活动的影响尚未得到分析。因此，在这项初步研究中，我们分析了5毫克速释褪黑素治疗的8例患者在首次REM睡眠期间褪黑素对EEG活动的影响。在一项单盲、安慰剂对照研究中，从额叶、中央、颞叶和枕叶头皮导联获得多导睡眠图记录。比较了安慰剂组和褪黑素组的REM睡眠潜伏期，以及六个EEG频段的相对功率（RP）和EEG相干性。结果显示，AD患者摄入褪黑素会减少REM睡眠起始，且这与较低的RP以及β和γ EEG频段的相干性有关。本文讨论了在轻度至中度AD中与REM睡眠产生相关的抑制性GABA能通路保存完好的可能性。我们得出结论，AD患者摄入褪黑素后REM睡眠起始时间缩短与RP和EEG相干性显著降低有关，主要是在高频段。
