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Melatonin dysregulation, sleep disturbances and fatigue in multiple sclerosis
Lena Melamud1, Daniel Golan, Rafael Luboshitzky
1Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, Haifa, Israel.
Background:
Sleep disruption and fatigue are common in Multiple Sclerosis (MS). Melatonin is one of the major regulators of sleep-wake cycle. The role of melatonin in MS-related sleep disturbances and fatigue as well as the interaction between melatonin and Interferon beta (IFN-β) treatment were the subject of this study.
Objective:
To assess the influence of IFN-β treatment on melatonin secretion, fatigue and sleep characteristics in patients with MS.
Methods:
13 MS patients and 12 healthy controls participated. Fatigue was evaluated using the Fatigue Impact Scale (FIS), sleep was assessed by actigraphy and day/night levels of 6-sulphatoxy-melatonin (6-SMT) in urine were determined using a highly specific ELISA assay.
Results:
Naïve MS patients demonstrated significantly decreased levels of 6-SMT and disrupted circadian regulation of its secretion, which were increased with IFN-β treatment, in association with improved fatigue. Sleep Efficiency was significantly lower in the MS group compared to controls.
Conclusion:
Our findings suggest dysregulation of Melatonin secretion in MS, which may be influenced by IFN-β treatment. The results call for further characterization of the role of neuro-hormones such as melatonin in MS, and their cross-regulation with immune-mediators.
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