|
|
|
| Clinical efficacy of Melatonin on sleep disorder and mood disorder in patients with traumatic brain injury |
| WU Chenrui WU Biying FUJiayuanyuan TAN Weilin ZHOU Qiang DU Mengran HUANG Xuekang LIAO Zhengbu#br# |
| Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China |
|
|
|
Abstract Objective To observe the clinical efficacy of Melatonin on sleep disorder and mood disorder in patients with traumatic brain injury. Methods A total of 27 patients with mild to moderate traumatic brain injury treated in the Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University from August 2019 to August 2021 were selected and divided into Melatonin group (13 cases) and control group (14 cases) by random number table method. The Melatonin group took Melatonin Capsules orally 30 minutes before falling asleep every night, while the control group took placebo orally 30 minutes before falling asleep every night. Both groups continued to take the drug for four weeks. After treatment, Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), hospital anxiety and depression scale (HADS), and Glasgow outcome scale-extended (GOS-E) were used to evaluate sleep disorder, mood disorder, and functional outcomes in the two groups. The incidence of adverse reactions during medication was recorded in both groups. Results After treatment, the PSQI, ESS, and HADS anxiety scores of Melatonin group were lower than those of control group, and the differences were statistically significant (P ＜ 0.05). There was no significant difference in HADS depression score and GOS-E score between the two groups (P ＞ 0.05). There was no significant difference in the incidence of fatigue, drowsiness, headache, dizziness, nausea, and vomiting between the two groups (P ＞ 0.05). Conclusion Melatonin can improve sleep disturbance and relieve anxiety after traumatic brain injury, with good safety.
|
|
|
|
|
|
[1] Mathias JL，Alvaro PK. Prevalence of sleep disturbances，disorders，and problems following traumatic brain injury：a meta-analysis [J]. Sleep Med，2012，13（7）：898-905.
[2] Ouellet MC，Beaulieu-Bonneau S，Morin CM. Sleep-wake disturbances after traumatic brain injury [J]. Lancet Neurol，2015，14（7）：746-757.
[3] Imbach LL，Büchele F，Valko PO，et al. Sleep-wake disorders persist 18 months after traumatic brain injury but remain underrecognized [J]. Neurology，2016，86（21）：1945-1949.
[4] Mahmood O，Rapport LJ，Hanks RA，et al. Neuropsychological performance and sleep disturbance following traumatic brain injury [J]. J Head Trauma Rehabil，2004，19（5）：378-390.
[5] Nakase-Richardson R，Sherer M，Barnett SD，et al. Prospective evaluation of the nature，course，and impact of acute sleep abnormality after traumatic brain injury [J]. Arch Phys Med Rehabil，2013，94（5）：875-882.
[6] Shekleton JA，Parcell DL，Redman JR，et al. Sleep disturbance and melatonin levels following traumatic brain injury [J]. Neurology，2010，74（21）：1732-1738.
[7] Larrabee GJ，Rohling ML. Neuropsychological differential diagnosis of mild traumatic brain injury [J]. Behav Sci Law，2013，31（6）：686-701.
[8] Buysse DJ，Reynolds CF，Monk TH，et al. The Pittsburgh Sleep Quality Index：a new instrument for psychiatric practice and research [J]. Psychiatry Res，1989，28（2）：193-213.
[9] Johns MW. A new method for measuring daytime sleepiness：the Epworth sleepiness scale [J]. Sleep，1991，14（6）：540-545.
[10] Zigmond AS，Snaith RP. The hospital anxiety and depression scale [J]. Acta Psychiatr Scand，1983，67（6）：361-370.
[11] Wilson JT，Pettigrew LE，Teasdale GM. Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale：guidelines for their use [J]. J Neurotrauma，1998，15（8）：573-585.
[12] Osier N，McGreevy E，Pham L，et al. Melatonin as a Therapy for Traumatic Brain Injury：A Review of Published Evidence [J]. Int J Mol Sci，2018，19（5）：1539.
[13] Grima NA，Rajaratnam S，Mansfield D，et al. Efficacy of melatonin for sleep disturbance following traumatic brain injury：a randomised controlled trial [J]. BMC Med，2018，16（1）：8.
[14] Grima NA，Rajaratnam S，Mansfield D，et al. Poorer sleep quality predicts melatonin response in patients with traumatic brain injury：findings from a randomized controlled trial [J]. J Clin Sleep Med，2021，17（8）：1545-1551.
[15] Wu C，Du M，Yu R，et al. A novel mechanism linking ferroptosis and endoplasmic reticulum stress via the circPtpn14/miR-351-5p/5-LOX signaling in melatonin-mediated treatment of traumatic brain injury [J]. Free Radic Biol Med，2022，178：271-294.
[16] Golombek DA，Martini M，Cardinali DP. Melatonin as an anxiolytic in rats：time dependence and interaction with the central GABAergic system [J]. Eur J Pharmacol，1993，237（2/3）：231-236.
[17] Pierrefiche G，Zerbib R，Laborit H. Anxiolytic activity of melatonin in mice：involvement of benzodiazepine receptors [J]. Res Commun Chem Pathol Pharmacol，1993，82（2）：131-142.
[18] Marseglia L，D’Angelo G，Manti S，et al. Analgesic，anxiolytic and anaesthetic effects of melatonin：new potential uses in pediatrics [J]. Int J Mol Sci，2015，16（1）：1209-1220.
[19] Arioz BI，Tastan B，Tarakcioglu E，et al. Melatonin Attenuates LPS-Induced Acute Depressive-Like Behaviors and Microglial NLRP3 Inflammasome Activation Through the SIRT1/Nrf2 Pathway [J]. Front Immunol，2019，10：1511.
[20] Ali T，Rahman SU，Hao Q，et al. Melatonin prevents neuroinflammation and relieves depression by attenuating autophagy impairment through FOXO3a regulation [J]. J Pineal Res，2020，69（2）：e12667.
[21] Madsen MT，Zahid JA，Hansen CH，et al. The effect of melatonin on depressive symptoms and anxiety in patients after acute coronary syndrome：The MEDACIS randomized clinical trial [J]. J Psychiatr Res，2019，119：84-94.
[22] Cardinali DP，Srinivasan V，Brzezinski A，et al. Melatonin and its analogs in insomnia and depression [J]. J Pineal Res，2012，52（4）：365-375.
[23] de Bodinat C，Guardiola-Lemaitre B，Moca?觕r E，et al. Agomelatine，the first melatonergic antidepressant：discovery，characterization and development [J]. Nat Rev Drug Discov，2010，9（8）：628-642.
[24] Rehman SU，Ikram M，Ullah N，et al. Neurological Enhancement Effects of Melatonin against Brain Injury-Induced Oxidative Stress，Neuroinflammation，and Neurodegeneration via AMPK/CREB Signaling [J]. Cells，2019， 8（7）：760.
[25] Weishaupt JH，Bartels C，P?觟lking E，et al. Reduced oxidative damage in ALS by high-dose enteral melatonin treatment [J]. J Pineal Res，2006，41（4）：313-323. |
|
|
|
