Circadian secretion pattern of melatonin in de novo parkinsonian patients: evidence for phase-shifting properties of l-dopa.

E Fertl, E Auff, A Doppelbauer, F Waldhauser
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引用次数: 103

Abstract

Aim of this study was the characterization of the circadian melatonin profile in de novo Parkinson patients (N = 9, age 60.0 +/- 3.2 years, mean +/- SEM) and the comparison of these profiles with those of controls and Parkinson patients treated with l-dopa/decarboxylase inhibitor (l-dopa/DCI). We collected 14 venous blood samples during a period of 24 hours and measured the serum melatonin levels by a radioimmuno assay. De novo Parkinson patients displayed the nocturnal melatonin peak (acrophase) at the same time as controls and significantly later than l-dopa/DCI treated patients (1:54 +/- 15.6 min [average clock time +/- SEM in minutes] vs. 1:45 +/- 15.6 min vs. 0:13 +/- 40.8 min). The amount of secreted melatonin did not differ among the three groups. Stage and duration of Parkinson's disease did not correlate with the amount of secreted melatonin. Patients of the tremor subgroup, however, secreted more melatonin than patients presenting only with rigidity and akinesia. The phase advance in Parkinson patients treated with l-dopa/DCI is possibly due to a central nervous dopaminergic effect elicited by l-dopa administration and not inherent to Parkinson's disease per se.

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新生帕金森患者褪黑激素的昼夜节律分泌模式:左旋多巴相移特性的证据。
本研究的目的是表征新生帕金森患者(N = 9,年龄60.0±3.2岁,平均±SEM)的昼夜褪黑激素特征,并将这些特征与对照组和接受左旋多巴/脱羧酶抑制剂(l-dopa/DCI)治疗的帕金森患者进行比较。我们在24小时内收集了14份静脉血样本,并通过放射免疫测定法测量了血清褪黑素水平。帕金森患者出现夜间褪黑激素高峰(峰期)的时间与对照组相同,明显晚于左旋多巴/DCI治疗的患者(1:54 +/- 15.6分钟[平均时钟时间+/- SEM以分钟计],1:45 +/- 15.6分钟,0:13 +/- 40.8分钟)。褪黑素的分泌量在三组之间没有差异。帕金森病的分期和病程与褪黑激素的分泌量无关。然而,震颤亚组患者分泌的褪黑素比仅表现为僵硬和运动障碍的患者多。帕金森患者接受左旋多巴/DCI治疗的期提前可能是由于左旋多巴引起的中枢神经多巴胺能作用,而不是帕金森病本身所固有的。
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