NEUROBIOLOGY OF SEASONAL AFFECTIVE DISORDER (SAD) AND LIGHT THERAPY

我们试图阐明季节性肺炎的病理生理学基础。 情感障碍(SAD)与光疗的作用机制。 我们以前报道过钝性下丘脑-垂体-肾上腺(HPA) 对使用促肾上腺皮质激素(CRH)的反应，以及 5-羟色胺激动剂m-CPP和爱普沙酮(见Z01 MH 022689-02 CPB)；以及 昼夜节律血浆催乳素水平异常低。我们报道了 有效的强光治疗与降低夜间活动有关 核心体温。在过去的一年里，我们在四个方面继续努力：a) 睡眠、核心体温和昼夜血浆的自然主义研究 激素谱；b)运动后血浆激素的测量 应激；c)立位后心率变异性的测量 挑战；以及，d)测量SAD患者的垂体大小(PTS) 和健康对照组(CRT)。 在第一组研究中，22摄氏度和22摄氏度的核心体温 对冬季和夏季的CRT进行了分析。昼夜节律 这些患者的血浆褪黑素测定在单独的 报告(Z01 MH 02687-02 CPB)。血液也被抽到了 夜间睡眠时的甲状腺功能(TSH、T3、T4和反T3)。 另外23个PTS和23个CRT经历了睡眠(包括光谱 分析)以及过去的核心身体和皮肤温度测量 冬天。PTS患者夜间核心体温显著降低 冬季高于夏季，但CRTS无季节性差异。 光疗降低夜间核心体温(复制 我们之前的一个发现)，并且减少与其 抗抑郁作用。去年冬季睡眠状况的初步分析 记录显示，PTS具有明显更高的REM密度和 睡眠周期更长，但没有其他异常。我们发现重要的是 PTS AS夜间TSH、T_3、T_4及反T_3升高 与冬季(未处理和光照处理)的CRTS相比 条件)和夏季。 我们还扩大了早期研究中的参与者数量，在该研究中 似乎绝经前SAD患者的生长激素水平 在冬天变钝(无论是在未经处理的条件下还是在光处理的条件下) 在夏天。另有四名临时技师和四名考勤人员在 跑步机上的血氧饱和度达到90%。数据分析正在进行中 最终结果等待这项研究夏季阶段的完成。 在第三项研究中，22个PTS和24个CRT在冬季7：30之间进行了研究 上午上午8：30心率变异性在休息和休息时都被测量 站立10分钟后进行频谱功率分析。数据 分析工作正在进行中，最终结果等待夏季结束。 本研究的阶段。最后，我们增加了参与者的数量 在我们正在进行的脑垂体大小的磁共振成像研究中 在去年冬天增加了8个PTS和8个CRT。资料分析 等待这项研究的夏季阶段完成。

We have attempted to clarify the pathophysiological basis of seasonal affective disorder (SAD) and the mechanism of action of light therapy. We previously reported on blunted hypothalamo-pituitary-adrenal (HPA) responses to the administration of corticotrophin (CRH), and the serotonin agonists m-CPP and ipsapirone (See Z01 MH 022689-02 CPB); and abnormally low circadian plasma prolactin levels. We reported that effective bright light therapy is associated with lowering of nocturnal core body temperature. This past year we continued in four ways: a) naturalistic studies of sleep, core body temperature and circadian plasma hormone profiles; b) measurement of plasma hormones following exercise stress; c) measurement of heart rate variability following orthostatic challenge; and, d) measurement of pituitary size in SAD patients (PTS) and healthy controls (CRTS). In the first set of studies, core body temperature from 22 PTS and 22 CRTS, studied both in winter and in summer were analyzed. Circadian plasma melatonin measures on these patients are presented in a separate report (Z01 MH 02687-02 CPB). Blood also was drawn to measures of thyroid function (TSH, T3, T4 and reverse T3) during nighttime sleep. An additional 23 PTS and 23 CRTS underwent sleep (including spectral analysis) and core body and skin temperature measurements this past winter. In PTS nocturnal core body temperature was significantly lower in winter than in summer but there was no seasonal difference in CRTS. Light therapy reduced nocturnal core body temperature (a replication of an earlier finding of ours) and the reduction was proportional to its antidepressant effects. Initial analysis of last winter's sleep recordings showed that PTS had significantly higher REM density and longer sleep cycles, but no other abnormalities. We found significantly elevated nocturnal values of TSH, T3, T4 and reverse T3 in PTS as compared with CRTS in winter (in both untreated and light treated conditions) and in summer. We also expanded the number of participants in an earlier study, in which it appeared that growth hormone levels in premenopausal women with SAD were blunted in winter (both in untreated and light-treated conditions) and in summer. An additional four PTS and four CRTS exercised on a treadmill to 90% of their oxygen saturation. Data analysis is underway and final results await completion of the summer phase of this study. In a third study, 22 PTS and 24 CRTS were studied in winter between 7:30 a.m. and 8:30 a.m. Heart rate variability was measured both at rest and 10 minutes after standing up and was analyzed for spectral power. Data analysis is underway and final results await completion of the summer phase of this study. Finally, we increased the number of participants in our ongoing study of magnetic resonance imaging of pituitary size by adding 8 additional PTS and 8 CRTS this past winter. Data analysis awaits completion of the summer phase of this study.