Circadian and sleep-related endocrine rhythms in schizophrenia.
Circadian and sleep-related endocrine rhythms in schizophrenia.
复制标题
DOI：
10.1001/archpsyc.1991.01810280064009
复制
发表时间：
1991-04
影响因子：
--
通讯作者：
E. Cauter;Paul Linkowski;Myriam Kerkhofs;P. Hubain;M. L’Hermite‐Balériaux;Raoul Leclercq;Michelle Brasseur;Georges Copinschi;Julien Mendlewicz
中科院分区：
文献类型：
--
作者：
E. Cauter;Paul Linkowski;Myriam Kerkhofs;P. Hubain;M. L’Hermite‐Balériaux;Raoul Leclercq;Michelle Brasseur;Georges Copinschi;Julien Mendlewicz
在9名未服药的男性精神分裂症患者和9名年龄匹配的正常男性受试者中，每隔15分钟测量一次催乳素、生长激素、促肾上腺皮质激素和皮质醇的血浆水平，持续24小时。每项研究之前都要对实验室环境进行3天的适应。睡眠被记录下来。使用专门设计用于分析激素波动的计算机算法定量表征了每个激素分布中存在的昼夜节律和脉动变化。在精神分裂症患者中观察到的神经内分泌释放的主要异常是催乳素水平的睡眠相关增加的几乎三倍增强，与夜间催乳素脉冲的强化频率相关。睡眠对催乳素分泌的刺激作用在睡眠开始后立即明显增加。精神分裂症患者在睡眠早期皮质醇分泌的正常抑制是不存在的。主要的睡眠异常是睡眠潜伏期延长和总的快速眼动期睡眠减少。在清醒期间，催乳素和皮质醇水平是正常的。精神分裂症患者的24小时生长激素曲线没有改变，所有患者都观察到睡眠发作的生长激素脉冲。促肾上腺皮质激素分泌的水平或时间组织未见异常。皮质醇节律的幅度和时间都是正常的。我们的结论是，在精神分裂症男性，垂体肾上腺功能和昼夜节律的时间保持是正常的，但催乳素分泌是高反应的生理刺激睡眠开始。因此，精神分裂症的特点似乎是一个子集的神经内分泌紊乱不同的观察到的主要内源性抑郁症。
Plasma levels of prolactin, growth hormone, corticotropin, and cortisol were measured at 15-minute intervals for 24 hours in nine unmedicated male schizophrenic patients and in nine age-matched normal male subjects. Each study was preceded by 3 days of habituation to the laboratory environment. Sleep was polygraphically recorded. The circadian and pulsatile variations present in each hormonal profile were quantitatively characterized with the use of computer algorithms specifically designed for analyses of hormonal fluctuations. The major abnormality of neuroendocrine release that was observed in the schizophrenic patients was an almost threefold enhancement of the sleep-related increase in the prolactin level, associated with an intensified frequency of nocturnal prolactin pulses. This increased stimulatory effect of sleep on prolactin secretion was evident immediately after sleep onset. The normal inhibition of cortisol secretion during early sleep was absent in schizophrenic patients. The major sleep abnormalities were a prolonged sleep latency and a reduction in total rapid eye movement stage sleep. During wakefulness, prolactin and cortisol levels were normal. The 24-hour profile of growth hormone was unaltered in schizophrenic patients, and a sleep-onset growth hormone pulse was observed in all patients. No abnormalities were noted in the levels or temporal organization of corticotropin secretion. Both the amplitude and the timing of the cortisol rhythm were normal. We conclude that, in schizophrenic men, pituitary-adrenal function and circadian time-keeping are normal but prolactin secretion is hyperresponsive to the physiologic stimulus of sleep onset. Schizophrenia thus appears to be characterized by a subset of neuroendocrine disturbances distinct from that observed in major endogenous depression.