NEUROBIOLOGY OF SEASONAL AFFECTIVE DISORDER (SAD) AND LIGHT THERAPY

我们试图阐明季节性心脏病的病理生理基础， 情感障碍（SAD）和光疗法的作用机制。 我们以前曾报道过钝性下丘脑-垂体-肾上腺（HPA） 对促肾上腺皮质激素（CRH）给药的反应， 5-羟色胺激动剂m-CPP和伊沙匹隆（参见Z 01 MH 022689-02 CPB）;和 异常低的昼夜血浆催乳素水平。 我们报道了 有效的强光疗法与降低夜间睡眠有关。 核心体温 在过去的一年里，我们继续在四个方面：a） 睡眠、核心体温和昼夜血浆的自然主义研究 激素谱; B）运动后血浆激素测量 压力; c）直立后心率变异性的测量 激发;和，d）SAD患者（PTS）中垂体大小的测量 健康对照组（CRTS）。 在第一组研究中，22例PTS和22例 分析了冬、夏两季的CRTS。 昼夜 这些患者的血浆褪黑激素测量结果在单独的 报告（Z 01 MH 02687-02 CPB）。 还抽取了血液， 甲状腺功能（TSH，T3，T4和反向T3）在夜间睡眠。 另外23例PTS和23例CRTS接受了睡眠（包括频谱 分析）和核心身体和皮肤温度测量这过去 冬天在PTS夜间核心体温显着降低 CRTS的季节差异不明显。 光疗法降低了夜间核心体温（ 我们的早期发现）和减少是成比例的， 抗抑郁作用 对去年冬天睡眠的初步分析 记录显示，PTS具有显著更高的REM密度， 睡眠周期延长但没有其他异常 我们发现 PTS患者夜间TSH、T3、T4和反向T3值升高， 与冬季对照相比（未处理和光照处理 条件）和夏季。 我们还扩大了早期研究的参与者数量，其中 患有SAD的绝经前妇女的生长激素水平似乎 在冬季钝化（在未经处理和光处理的条件下） 在夏天。 另有四名临时秘书处和四名皇家空间技术中心在一个 将他们的氧饱和度调到90% 数据分析正在进行中 最后结果有待这项研究的夏季阶段完成。 在第三项研究中，22个PTS和24个CRTS在冬季7：30 上午和上午8：30。心率变异性在休息和 站立10分钟后，分析光谱功率。 数据 分析正在进行中，最终结果将在夏季完成 这个研究的阶段。 最后，我们增加了参与者的数量， 在我们正在进行的垂体大小磁共振成像的研究中， 今年冬天增加了8个PTS和8个CRTS。 数据分析 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.