Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Yang-Ming Chiao Tung University and Academia Sinica, Taipei, Taiwan.
Division of Neuroscience, 71563Institute of Biomedical Sciences Academia Sinica, Taipei, Taiwan.
Mol Pain. 2022 Apr;18:17448069221127180. doi: 10.1177/17448069221127180.
The devastating chronic central post stroke pain is associated with variety of comorbidities. Disrupted sleep is a severe comorbidity, causing an increase in the suicide rate, due to CPSP's pain symptom. Melatonin is a well-known jet-lag compound, which helps in entrainment of sleep cycle. Accordingly, whether melatonin as a therapeutic measurement for the regulation of sleep disturbance related to central post stroke pain remains unclear. Exogenous melatonin administration entrained the disrupted 24 h circadian cycle, more effectively after 2 and 3 week of administration. The effect of melatonin was persisted on 4th week too, when melatonin administration was discontinued. Also, melatonin ameliorated the pain due to distorted sleep-activity behavior after melatonin administration for 3 weeks. The low levels of melatonin in blood plasma due to CPSP were restored after 3 weeks of melatonin administration. After 30 mg/kg melatonin administrations for 3 weeks, all the disrupted resting and activity behaviors were reduced during light and dark periods. The results suggested that melatonin significantly ameliorated CPSP's pain symptoms and comorbid sleep disturbance showing in activity behavior.
致残性慢性中枢性卒中后疼痛与多种合并症相关。睡眠紊乱是一种严重的合并症，由于 CPSP 的疼痛症状，导致自杀率增加。褪黑素是一种众所周知的时差化合物，有助于调整睡眠周期。因此，褪黑素作为一种治疗措施，用于调节与中枢性卒中后疼痛相关的睡眠障碍是否有效尚不清楚。外源性褪黑素给药使 24 小时昼夜节律紊乱得到纠正，在给药 2 周和 3 周后效果更明显。当褪黑素给药停止时，褪黑素的作用仍持续到第 4 周。此外，在给予褪黑素治疗 3 周后，褪黑素改善了因睡眠-活动行为紊乱引起的疼痛。由于 CPSP，血浆中褪黑素水平降低，在给予褪黑素 3 周后恢复正常。在给予 30mg/kg 褪黑素治疗 3 周后，在光照和黑暗期间，所有紊乱的休息和活动行为均减少。结果表明，褪黑素显著改善了 CPSP 的疼痛症状和以活动行为表现出来的合并睡眠障碍。
