Intrinsic Circadian Period of Sighted Patients with Circadian Rhythm Sleep Disorder, Free-Running Type
Intrinsic Circadian Period of Sighted Patients with Circadian Rhythm Sleep Disorder, Free-Running Type
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DOI：
10.1016/j.biopsych.2012.06.027
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发表时间：
2013-01-01
影响因子：
10.6
通讯作者：
Mishima, Kazuo
中科院分区：
文献类型：
--
作者：
Kitamura, Shingo;Hida, Akiko;Mishima, Kazuo
背景资料：自由奔跑型昼夜节律睡眠障碍（FRT）是一种顽固性睡眠障碍，即使在正常的生活环境中，睡眠和清醒时间也会逐渐延迟。这种疾病严重影响患者的社会功能，因为周期性的夜间失眠，白天过度嗜睡，以及高比例的共病精神障碍。虽然生物钟的异常调节被怀疑，FRT的病理生理学尚未阐明。在这项研究中，内源性昼夜节律周期，tau，FRT患者视力正常进行了比较与健康人的昼夜节律被夹带到一个24小时cycle.Methods：6 FRT患者和17名健康人（9个中间的时间型和8个晚上的时间型）进行了7天，28小时的睡眠觉醒时间表，根据强迫desperry协议。褪黑激素节律的相移进行了测量，在恒定的常规条件下计算Taut.Results：在FRT患者，tau显着长于中间的时间型，而在晚上的时间型，它的范围广泛，并没有显着不同的FRT患者。此外，在FRT患者的褪黑激素节律的tau蛋白没有表现出显着的相关性与tau蛋白的睡眠-觉醒cycles.Conclusions：研究结果表明，虽然延长的tau蛋白可能参与FRT的发病机制，延长的tau蛋白不是唯一的因素。似乎包括昼夜节律异常夹带在内的几个因素以多层方式参与了FRT的发病。
Background: Circadian rhythm sleep disorder, free-running type (FRT), is an intractable sleep disorder in which sleep and wake times progressively delay each day even in normal living environments. This disorder severely affects the social functioning of patients because of periodic nighttime insomnia, excessive daytime sleepiness, and a high rate of comorbid psychiatric disorders. Although abnormal regulation of the biological clock is suspected, the pathophysiology of FRT has yet to be elucidated. In this study, the endogenous circadian period, tau, of FRT patients with normal vision was compared with that of healthy individuals whose circadian rhythms are entrained to a 24-hour cycle.Methods: Six FRT patients and 17 healthy individuals (9 intermediate chronotypes and 8 evening chronotypes) were subjected to a 7-day, 28-hour sleep-wake schedule according to the forced desynchrony protocol. Phase shifts in melatonin rhythm were measured under constant routine conditions to calculate tau.Results: In FRT patients, tau was significantly longer than in intermediate chronotypes, whereas in evening chronotypes, it ranged widely and was not significantly different from that in FRT patients. Moreover, tau of melatonin rhythm in FRT patients showed no significant correlation with tau of sleep-wake cycles measured before the study.Conclusions: The findings suggest that although a prolongation of tau may be involved in the onset mechanism of FRT, a prolonged tau is not the only factor involved. It appears that several factors including abnormal entrainment of circadian rhythms are involved in the onset of FRT in a multilayered manner.