CHRONOBIOLOGICAL EVALUATION OF RAPID-CYCLING BIPOLAR DISORDER

快速循环双相情感障碍的时间生物学评估

• 批准号: 6162896
• 负责人: E LEIBENLUFT
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6162896
• 关键词: bioperiodicity; bipolar depression; circadian rhythms; clinical research; cortisol; electroencephalography; hormone regulation /control mechanism; human subject; longitudinal human study; melatonin; prolactin; sleep disorders; somatotropin; thyrotropin

Data show that the circadian phase at which sleep and wakefulness occur can influence mood in both patients with mood disorders and in normal volunteers. The purpose of this project is to characterize the contributions of these sleep-wake and circadian effects to mood regulation in patients with rapid cycling bipolar disorder (RCBD), who experience at least four episodes of mania, hypomania, and/or depression in a year. The studies in this project include a cross-sectional study of sleep and hormonal secretion in hypomania and depression; naturalistic studies of the relationship between mood and sleep in patients with RCBD; and a forced desynchronization protocol. Results from the cross-sectional study show that the rhythms of melatonin, TSH, and cortisol vary with sleep timing and duration as the patients' moods cycle. Data from the naturalistic studies show that morning zeitgebers ("time-givers", entraining agents) and wake onset play a more significant role than evening zeitgebers and sleep onset in the pathophysiology of RCBD. In addition, these studies show a diurnal variation in the direction of mood switches in patients with RCBD, and demonstrate that there is no systematic relationship between menstrual cycle phase and mood in premenopausal women with RCBD. In the forced desynchronization protocol, patients are placed on a 28-hour day for thirteen days and frequent mood ratings are performed. Since the human circadian pacemaker cannot entrain to a 28-hour day, this protocol allows for the systematic dissociation of circadian and sleep-wake effects on mood.

数据显示，睡眠和觉醒发生的昼夜节律阶段 可以影响情绪障碍患者和正常患者的情绪 志愿者。这个项目的目的是描述 这些睡眠-觉醒和昼夜节律效应对情绪调节的贡献 在快速循环型双相情感障碍(RCBD)患者中， 一年内至少出现四次躁狂、轻躁和/或抑郁。这个 该项目的研究包括对睡眠和睡眠的横断面研究 轻躁狂和抑郁症的激素分泌；自然主义研究 RCBD患者的情绪和睡眠之间的关系 强制解除同步协议。横断面研究的结果 表明褪黑激素、促甲状腺激素和皮质醇的节律随着睡眠的变化而变化 时间和持续时间作为患者的情绪周期。数据来自 自然主义研究表明，早晨的时代思潮(“时间给予者”， 携带剂)和尾流开始起到比 RCBD病理生理学中的夜间发作和睡眠开始。在……里面 此外，这些研究表明，情绪的方向每天都会发生变化 在RCBD患者中进行切换，并证明没有 女性月经周期与情绪的系统关系 绝经前女性RCBD。在强制去同步协议中， 患者被安排在一天28小时的时间里工作13天，并经常情绪激动 进行评级。因为人类昼夜节律起搏器不能携带 到一天28小时，这一协议允许系统地分离 昼夜节律和睡眠-觉醒对情绪的影响。