| 멜라토닌의 일중 분비에 대한 급성 뇌경색의 영향 |
| 이지용, 문준식 한범기 양현덕 권준범 이성익 이성수 |
| 연세대학교 원주의과대학 신경과학교실 |
| "The Influence of Acute Cerebral Infarction on the
Circadian Rhythm of Melatonin Secretion" |
| "Ji-Yong Lee, M.D., Joon-Shik Moon, M.D., Bum-Gi Han, M.D., Hyun-Duk Yang, M.D.,
Joon-Bum Kwon, M.D., Sung-Ik Lee, M.D., Sung-Soo Lee, M.D." |
| Department of Neurology, Yonsei University Wonju College of Medicine |
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| Abstract |
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"Background : The circadian rhythm of circulating melatonin is regulated by the endogenous oscillators, the suprachi-asmatic
nuclei, and entrained by the light-dark cycle of the environment, but it seems that the rhythm can be affected by
variable lesions outside the retina-pineal pathway. We intended to know how acute cerebral infarction affects on the cir-cadian
rhythm of plasma melatonin secretion. Methods : Plasma melatonin level was measured from 64 patients with
acute cerebral infarction. On admission, blood samples were collected by venipuncture at 2AM, 4AM, 10AM, and 2PM
and melatonin level was measured by radioimmunoassay. The state of consciousness of each patient was assessed clini-cally
and the infarction site and size were evaluated clinically and radiographically. Results : Among 64 patients with
acute cerebral infarction, dramatic blunting or obliteration of nocturnal melatonin surge in the blood was found in 29
patients. The circadian rhythm of melatonin secretion was absent in 12 of 35 alert patients, in 10 of 20 drowsy patients,
and in 5 of 7 stuporous patients. Melatonin secretion into plasma was markedly decreased in all 2 comatose patients. Of
14 patients with brainstem lesions, 8 patients showed decreased melatonin levels with the absence of a nocturnal rise,
although most of them were alert. Conclusions : This study suggests that brainstem and the initial mental state might
contribute to the regulation of the circadian rhythm of plasma melatonin even though the lesion does not involve the
retina-pineal pathway, but further extensive study is required to elucidate it. J Korean Neurol Assoc 19(4):359~363, 2001 Key Words : Melatonin, Cerebral Infarction, Pineal gland, Circadian rhythm" |
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