The use of chronobiotics in the resynchronization of the sleep/wake cycle. Therapeutical application in the early phases of Alzheimer's disease.

摘要: Treatment of circadian rhythm disorders, whether precipitated by intrinsic factors (e.g., sleep blindness, mental aging) or extrinsic shift work, jet-lag) has led to the development a new type agents called “chronobiotics”. The term “chronobiotic” defines substance displaying therapeutic activity shifting phase increasing amplitude rhythms. prototype this group is melatonin, whose administration synchronizes sleep-wake cycle in blind people and individuals suffering from like delayed syndrome, jet lag shift-work. Daily melatonin production decreases with age, several pathologies, attaining its lowest values Alzheimers disease (AD) patients. About half dementia patients have severe disruptions their sleep-wakefulness cycle. Melatonin replacement effective treat sundowning other wake disorders fully developed AD, although controversial data on point exist. Indeed, large interindividual differences between AD exist can explain these erratic results. Theoretically effect could be more consistent at an earlier stage disease, i.e., mild cognitive impairment (MCI), etiologically heterogeneous syndrome that precedes dementia. PubMed was searched using Entrez for articles including clinical trials. Search terms were “Alzheimer” “mild impairment” “melatonin”. Full publications obtained references checked additional material where appropriate. Only studies empirical treatment reviewed. Five double blind, randomized placebo-controlled trials 1 open-label retrospective study (N = 651) all agree indicating daily evening improves quality performance MCI. analysis published evidence patents indicates useful ad-on tool early phases AD.