Uchida K, Okamoto N, Ohara K, Morita Y
First Department of Physiology, Hamamatsu University School of Medicine, Japan.
Brain Res. 1996 Apr 22;717(1-2):154-9. doi: 10.1016/0006-8993(96)00086-8.
The daily rhythm in serum melatonin levels was measured in patients with dementia of the degenerate type (Alzheimer's disease, Pick's disease and senile dementia of the Alzheimer type) by radioimmunoassay. Thirteen patients (age: 69.0 +/- 8.0 years, mean +/- S.D.) were studied. All patients were hospitalized at the time of the study and had a history of sleep-wake disturbances, nocturnal wandering and/or delirium. We also studied 13 age-matched healthy control subjects (control group 1), ten young adults (control group 2), and nine hospitalized patients without dementia (control group 3). Two subjects in the control groups showed no measurable changes in melatonin level throughout the day, while the other 30 control subjects exhibited a clear daily rhythm with the peak concentration occurring during the night. On the other hand, four out of the 13 patients with dementia did not show any melatonin rhythm. Two of the demented patients who did not exhibit melatonin rhythm displayed clinical symptoms of rhythm disorders. One out of the nine patients with melatonin rhythm presented with clinical symptoms, such as delirium and sleep-wake disturbance. Our results suggest that the probability of absent melatonin rhythm is higher in demented patients compared with subjects without dementia. However, a lack of melatonin rhythm is not always associated with symptomatic rhythm disorders. Since the melatonin rhythm reflects that of the suprachiasmatic nucleus, it follows that the SCN function of the patients having a history of rhythm disorders was not always severely damaged.
通过放射免疫分析法，对退行性痴呆类型（阿尔茨海默病、匹克病和阿尔茨海默型老年痴呆）患者血清褪黑素水平的每日节律进行了测量。研究了13名患者（年龄：69.0±8.0岁，均值±标准差）。所有患者在研究时均住院，并有睡眠-觉醒障碍、夜间徘徊和/或谵妄病史。我们还研究了13名年龄匹配的健康对照受试者（对照组1）、10名年轻成年人（对照组2）和9名无痴呆的住院患者（对照组3）。对照组中有两名受试者全天褪黑素水平无明显变化，而其他30名对照受试者呈现出明显的每日节律，夜间浓度达到峰值。另一方面，13名痴呆患者中有4名未表现出任何褪黑素节律。两名未表现出褪黑素节律的痴呆患者出现了节律紊乱的临床症状。9名有褪黑素节律的患者中有1名出现了如谵妄和睡眠-觉醒障碍等临床症状。我们的结果表明，与无痴呆的受试者相比，痴呆患者中缺乏褪黑素节律的可能性更高。然而，缺乏褪黑素节律并不总是与有症状的节律紊乱相关。由于褪黑素节律反映了视交叉上核的节律，因此有节律紊乱病史的患者的视交叉上核功能并非总是严重受损。
