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Effect of melatonin intake on postural balance, functional mobility and fall risk in persons with multiple sclerosis:
Sonda Jallouli1,2, Sameh Ghroubi1,3, Imen Ben Dhia1,2
1Research laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
Aim:
To assess the safety and the effect of a nocturnal melatonin (MEL) ingestion on postural balance, functional mobility and fall risk the following morning in adults with multiple sclerosis (MS).
Methods:
Fourteen adults with relapsing-remitting MS (RR-MS) (28.36 ± 6.81 years) were evaluated before and after nocturnal ingestion of MEL (6 mg) or placebo (PLA). Evaluations included a posturographic test of static bipedal postural balance with dual-task in eyes open (EO) and eyes closed conditions, and a clinical test of unipedal balance. The physical performance tests were: Timed Up and Go test (TUGT) (mobility), Four Square Step Test (FSST) (fall risk), and Timed 25-foot walk test (T25FWT) (walking speed). Cognitive performance [Montreal Cognitive Assessment (MoCA) and Simple Reaction Time (SRT) tests] and sleep quality [Spiegel's sleep questionnaire (SSQ)] were also assessed.
Results:
In EO condition, MEL decreased the posturographic parameters [center of pressure (CoP) sway area (CoPAr), CoP path length (CoPL) and CoPL in the mediolateral axis (CoPLX)] more than PLA by 15.82% (p = 0.0006), 12.48% (p = 0.0004) and 14.25% (p = 0.0002), respectively. Durations of TUGT and FSST decreased following MEL session more than the PLA one by 14.52% (p = 0.017) and 19.85% (p = 0.0006), respectively. MEL increased the unipedal stance time, SSQ and MoCA scores more than PLA by 49.81% (p = 0.04), 32.21% (p = 0.004) and 11.87% (p = 0.008), respectively.
Conclusion:
This pilot study showed that acute nocturnal MEL ingestion seems to be safe for enhancing postural balance, fun mobility and fall risk in RR-MS adults probably through improving sleep quality and cognitive function.
Insights
Nocturnal melatonin (MEL) ingestion improved postural balance, functional mobility, and reduced fall risk in adults with multiple sclerosis (MS) the following morning. This suggests MEL is safe and beneficial for MS patients, potentially by enhancing sleep and cognitive function.
Area of Science:
- Neurology
- Sleep Medicine
- Rehabilitation Science
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease affecting balance, mobility, and fall risk.
- Sleep disturbances are common in MS and can exacerbate neurological symptoms.
- Melatonin (MEL) is a hormone known for its role in sleep regulation and has potential neuroprotective effects.
Purpose of the Study:
- To evaluate the safety and efficacy of nocturnal melatonin (MEL) ingestion.
- To assess the impact of MEL on postural balance, functional mobility, and fall risk in adults with relapsing-remitting MS (RR-MS) the next morning.
Main Methods:
- A pilot study involving 14 adults with RR-MS.
- Participants underwent evaluations before and after ingesting 6 mg of MEL or placebo (PLA) nocturnally.
- Assessments included posturography, unipedal balance tests, Timed Up and Go Test (TUGT), Four Square Step Test (FSST), Timed 25-foot walk test (T25FWT), cognitive tests (MoCA, SRT), and sleep quality questionnaire (SSQ).
Main Results:
- MEL significantly improved postural balance, indicated by reduced center of pressure (CoP) sway in eyes-open conditions compared to PLA.
- Functional mobility and fall risk were improved with MEL, as shown by decreased TUGT and FSST durations.
- MEL also enhanced unipedal stance time, sleep quality (SSQ), and cognitive function (MoCA) compared to placebo.
Conclusions:
- Acute nocturnal melatonin ingestion appears safe for adults with RR-MS.
- MEL may enhance postural balance, functional mobility, and reduce fall risk in RR-MS patients.
- Improvements may be attributed to enhanced sleep quality and cognitive function.
