Therapeutic mechanism of vitamin B12 on sleep wake-rhythm disorders

11.研究对象：8名男性正常人，平均年龄(36.5±11.2)岁。2.药物：甲钴胺(B12)500μ，静脉注射。或生理盐水(安慰剂)1ml静脉注射。(23：00)3.测定1)血浆B12浓度(23：00，8：00)2)PSG(0：00-7：30)。3)精神运动警戒任务(PVT)；4)视觉模拟评分(VAS)；4)PSG测试后次晨8：00、9：00、11：00、13：00。结果给予B12后，B12的浓度显著升高。(280.0±90.1→1876.7±132 7.3pg/ml，p&lt；0.0 5)2)睡眠参数无静态变化。3)CAP率显著降低。(37.1±14.6→31.1±15.1%，p=0.0499)对象：符合ICSD-I型心理生理性失眠诊断标准的女性失眠患者8例，平均年龄36.5±11.2岁。结果1)B12浓度显著升高；2)睡眠参数无明显变化；3)CAP时间、CAP发生率、CAP周期数、A1亚型数显著减少。(CAP率：62.6±10.3PV53.4±10.4%，P=0.028)4)第二天早晨主观睡眠质量和→变量无明显变化。结论上述结果再次证实日本PPI患者的CAP率增加(62.6%)，与国外失眠症患者相同，提示外周输注B12可能具有增强失眠症患者睡眠稳定性的能力。提示B12可能通过抑制失眠症患者的皮质下觉醒而作用于睡眠控制系统，尤其是A1亚型。

Our goal of this study was to clarify the therapeutic mechanism of B12 on sleep in insomniacs by means of polysomnograghy (PSG) using cyclic alternative pattern (CAP) method.Step 11. Subjects : 8 male normal subjects (mean age;36.5±11.2y)2. Drug : methylcobalamine(B12) 500μg i.v. or saline (placebo) 1ml i.v. (23:00)3. Measurements1) Plasma concentration of B12 (23:00,8:00)2) PSG(0:00-7:30. PSG data were analyzed visually using conventional and CAP method)3) Psychomotor vigilance task (PVT)4) Visual analog scale (VAS)3),4) items were performed 8:00,9:00,11:00, and 13:00 next morning after PSG test.4. ResultsBy the administration of B12...1) Concentration of B12 significantly increased. (280.0±90.1→1876.7±1327.3pg/ml, p<0.05)2) Sleep parameters were not statically changed.3) CAP rate was significantly decreased. (37.1±14.6→31.1±15.1%,p=0.0499)Step 21. Subjects: 8 female insomnia patients (mean age;36.5±11.2y), who met the diagnosis of psychophysiological insomnia (PPI) in ICSD-I.2. Drug and Measurements : the same as those of Step 13. ResultsBy the administration of B12...1) Concentration of B12 significantly increased.2) Sleep parameters were not statically changed.3) CAP time, CAP rate, the number of CAP cycles, and the number of subtype Al were significantly decreased. (CAP rate:62.6 ±10.3→53.4±10.4%,P=0.028)4) Subjective sleep quality and PVT variables were not changed next mornings.ConclusionFrom the above-mentioned results, it was reconfirmed that CAP rate in Japanese PPI patients increased (62.6%) as well as those in insomnia patients of oversea.Furthermore, our findings suggested that peripherally infused B12 might have the ability of enforcing sleep stability in insomnia patients. It was also suggested that B12 might act on sleep control system via suppressing subcortical arousal in insomnia patients, because subtype Al was especially decreased.