Neural Correlates of Sleep Recovery following Melatonin Treatment for Pediatric Concussion: A Randomized Controlled Trial: Journal of Neurotrauma, Ahead of Print.Evidence-based treatments for children with persistent post-concussion symptoms (PPCS) are few and limited. Common PPCS complaints such as sleep disturbance and fatigue could be ameliorated via the supplementation of melatonin, which has significant neuroprotective and anti-inflammatory properties. This study aims to identify neural correlates of melatonin treatment with changes in sleep disturbances and clinical recovery in a pediatric cohort with PPCS. We examined structural and functional neuroimaging (fMRI) in 62 children with PPCS in a randomized, double-blind, placebo-controlled trial of 3 mg or 10 mg of melatonin (NCT01874847). The primary outcome was the total youth self-report Post-Concussion Symptom Inventory (PCSI) score after 28 days of treatment. Secondary outcomes included the change in the sleep domain PCSI score and sleep-wake behavior (assessed using wrist-worn actigraphy). Whole-brain analyses of (1) functional connectivity (FC) of resting-state fMRI, and (2) structural gray matter volumes via voxel-based morphometry were assessed immediately before and after melatonin treatment and compared with placebo to identify neural effects of melatonin treatment. Increased FC of posterior default mode network (DMN) regions with visual, somatosensory, and dorsal networks was detected in the melatonin groups over time. The FC increases also corresponded with reduced wake periods (r = -0.27, p = 0.01). Children who did not recover (n = 39) demonstrated significant FC increases within anterior DMN and limbic regions compared with those who did recover (i.e., PCSI scores returned to pre-injury level, n = 23) over time, (p = 0.026). Increases in GM volume within the posterior cingulate cortex were found to correlate with reduced wakefulness after sleep onset (r = -0.32, p = 0.001) and sleep symptom improvement (r = 0.29, p = 0.02). Although the melatonin treatment trial was negative and did not result in PPCS recovery (with or without sleep problems), the relationship between melatonin and improvement in sleep parameters was linked to changes in function-structure within and between brain regions interacting with the DMN.
Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
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- Serum cystatin C: A potential predictor for hospit...
- Management Strategies of Ocular Chemical Burns: Cu...
- A Real-World Study of Dexamethasone Implant in Tre...
- Collagen-Supplemented Incubation Rapidly Augments ...
- The effect of vitamin D supplementation on surviva...
- Cytotoxic CD8+ T cells in cancer and cancer immuno...
- Autophagy as a therapeutic target in pancreatic ca...
- Can Straw Phonation Be Considered As Vocal Warm Up...
- Extraarticular extrasynovial solitary osteochondro...
- Neural Correlates of Sleep Recovery following Mela...
- Subjects with temporomandibular joint disc displac...
- defective endocytosis and proximal tubule dysfunct...
- Uncaria tomentosa reduces osteoclastic bone loss
- Intestinal resection affects whole-body arginine s...
- Understanding the mechanisms of placebo and nocebo...
- Prognostic Factors, Treatment, and Survival in Pri...
- Use of Autologous, Noncultured Melanocyte–Keratino...
- Guidance for the Management of Patients with Vascu...
- Strip Graft of the Eyebrow for the Treatment of Tr...
- A Large Defect on the Cheek
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- Electron Microscopy of Argyria Treated With Picose...
- The Perialar Crescentic Advancement Flap: A Workho...
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- Catamenial Exacerbations of Cutaneous Neoplasms
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- Nanosecond Pulsed Electric Field Treatment of Sebo...
- Use of Lasers for Iron-Induced Accidental Tattoos:...
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