Circadian rhythm of catecholamines, cortisol and prolactin is altered in patients with apallic syndrome in comparison with normal volunteers.

Circadian rhythms of catecholamines, cortisol and prolactin were investigated in 4 healthy subjects and in 6 patients suffering from an apallic syndrome. The clinical picture of this syndrome is characterized by disturbed consciousness (coma vigile), suspension of the sleeping and waking rhythm, lack of emotional reactions and appearance of primitive motor patterns. With the exception of dopamine a pronounced circadian rhythm was found in the control group for all investigated parameters. Catecholamines and cortisol showed a good correlation in the temporal pattern of plasma concentrations and urinary excreted amounts. In all apallic patients the circadian rhythm of prolactin was abolished. Only in one patient a rhythm of catecholamines and in 2 patients a rhythm of cortisol was still detectable. The data may indicate that the episodic nature of hormone secretion was essentially unaffected by the apallic syndrome. These results are regarded as an indication that endogenous, centrally controlled processes participate in circadian rhythms.