Sandyk R, Bamford C R, Iacono R P
Department of Neurology, University of Arizona, Tucson 85724.
Int J Neurosci. 1987 Nov;37(1-2):59-65. doi: 10.3109/00207458708991801.
Sleep disorders have been reported in approximately 80% of Tourette's syndrome (TS) patients. Sleep studies in TS patients have demonstrated a 30% reduction in delta-sleep (slow-wave sleep) in nontreated subjects, decreased percentage of REM-sleep and the presence of tics during sleep. A subgroup of young TS patients was reported to have an increased percentage of delta sleep. Although these findings were initially thought to result from deranged dopaminergic and serotoninergic functions in TS, we suggest that abnormalities of hypothalamic-mediated control mechanisms involving the intrinsic opioids may also account for the observed derangements in sleep-wave patterns in TS patients. Evidence for impaired hypothalamic regulation in TS patients includes our preliminary observations of abnormal growth-hormone release to administration of the opiate antagonist naloxone in TS. These data further suggest an interrelationship of neurochemical mechanisms involving opioid-mediated hyperactivity, slow-wave sleep and growth hormone at the level of the hypothalamus.
据报道，约80%的抽动秽语综合征（TS）患者存在睡眠障碍。对TS患者的睡眠研究表明，未经治疗的受试者慢波睡眠减少30%，快速眼动睡眠百分比降低，且睡眠期间存在抽动症状。据报道，一小部分年轻TS患者的慢波睡眠百分比增加。尽管这些发现最初被认为是TS患者多巴胺能和5-羟色胺能功能紊乱所致，但我们认为，涉及内源性阿片类物质的下丘脑介导控制机制异常也可能是TS患者睡眠波型紊乱的原因。TS患者下丘脑调节受损的证据包括我们对TS患者注射阿片拮抗剂纳洛酮后生长激素释放异常的初步观察。这些数据进一步表明，在下丘脑水平上，涉及阿片介导的多动、慢波睡眠和生长激素的神经化学机制之间存在相互关系。
