Melatonin secretion in patients with spinal cord injury

• Published in: Annals of physical and rehabilitation medicine Vol. 61; p. e243
• Main Authors: Daville-blicq, R., Quera Salva, M.A., Ben Smail, D.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.07.2018
• Subjects: Melatonin; Sleep; Spinal cord injury; Spinal cord injury; Melatonin; Sleep
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2018.05.564

We evaluated the secretion of melatonin and the sleep quality in spinal cord injury patients versus healthy volunteers. This observational non-randomised study was conducted from June 2016 to January 2018 includes tetraplegics, paraplegics and healthy volunteers. Urinary 6-sulfatoxy-melatonin (U6SM) was measured during 5 period per day (8h–12h; 12h–16h; 16h–20h; 20h–00h; 00h–8h). Sleep quality was evaluated on Pittsburgh Sleep Quality Index and sleepiness on Epworth Sleepiness Scale. Correlation between U6SM dosage and sleep quality and sleepiness was analysed. Preliminary results 12 tetraplegic patients AIS A and B (10 men and 2 women) and 7 paraplegics AIS A and B were included in the study. No patient took neuroleptics or beta-blockers. No patient had a brain trauma associated. Eight tetraplegic patients (66.6%) had an absence of melatonin secretion, 4 (33.3%) had a decreased secretion with a shift of melatonin secretion. Unlike data of the literature, secretion of melatonin was not strictly normal in paraplegic patients: 4 (57.1%) had an absence of melatonin secretion, one T10 AIS A patient had a shift of melatonin secretion, 2 (28.5%) T9 and T10 AIS A patients had a normal melatonin secretion. The Pittsburgh Sleep Quality Index showed a poor sleep quality in tetraplegics (10.18±4.62) versus (7.57±3.64) in paraplegics and Epworth Sleepiness Scale showed a moderate sleepiness in tetraplegics (11.18±4.30) versus (4.57±2.50) in paraplegics. Secretion of melatonin is abnormal in patients with tetraplegia. It may partly explain sleep impairment of patients with tetraplegia. Further studies are needed to better understand the impact of this absence of melatonin secretion and to assess the effect of melatonin treatment in this population of patients.