Article

Sleep disturbance after pinealectomy in patients with pineocytoma WHO°I.

Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Acta Neurochirurgica (Impact Factor: 1.79). 06/2012; 154(8):1399-405; discussion 1405. DOI: 10.1007/s00701-012-1409-y
Source: PubMed

ABSTRACT Because the pineal gland produces melatonin, it is suggested to be involved in the regulation of sleep and circadian rhythm, though there is scant proof of this. Tumors of the pineal gland are rare and various in terms of histological and biological malignancy. We evaluated the occurrence of subjective sleep disturbances in nine patients who underwent a pinealectomy due to pineocytoma WHO°I without additional therapy.
Patients with intracranial low-grade lesions and patients without a craniotomy who underwent a microscopic lumbar discectomy were matched to our study group by gender, age, and date of surgery. We used standardized sleep questionnaires on sleepiness during the daytime, sleep disturbances, and general pathologic sleep patterns.
Patients who underwent a craniotomy either without a pinealectomy (7.2 ± 2.0 points) or with a pinealectomy experienced increased sleep disturbances (6.6 ± 1.3 points) compared to patients who had a lumbar discectomy (2.8 ± 0.4 points), according to the Pittsburgh Sleep Quality Index (PSQI) (p < 0.05). Moreover, sleep disturbances as measured by the insomnia severity index (ISI) were most pronounced in patients who underwent a craniotomy without a pinealectomy (10.4 ± 3.1 points) compared to patients who underwent a pinealectomy or discectomy (5.9 ± 1.9 and 3.3 ± 1.3 points).
Pinealectomy itself did not cause specific sleep impairment, but craniotomy in general did. This interesting and clinically relevant finding needs further investigation.

Download full-text

Full-text

Available from: Bernhard Meyer, Jun 18, 2015

Click to see the full-text of:

Article: Sleep disturbance after pinealectomy in patients with pineocytoma WHO°I.

239.92 KB

See full-text
2 Followers
 · 
424 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sleep and wake are actively promoted states of consciousness that are dependent on a network of state-modulating neurons arising from both the brain stem and hypothalamus. This network helps to coordinate the occurrence of a sleep state in billions of cortical neurons. In many neurological diseases, there is a specific disruption to one of the components of this network. Under conditions of such disruptions, we often gain an improved understanding of the underlying function of the specific component under nonpathological conditions. The loss or dysfunction of one of the hypothalamic or brain stem regions that are responsible for promotion of sleep or wake can lead to disruptions in sleep and wake states that are often subtle, but sometime quite pronounced and of significant medical importance. By understanding the neural substrate and its pathophysiology, one can more appropriately target therapies that might help the specific sleep disruption. This chapter reviews what is currently understood about the neurobiological underpinnings of sleep and wake regulation and how various pathologies evoke changes in these regulatory mechanisms.
    Progress in molecular biology and translational science 01/2013; 119:137-54. DOI:10.1016/B978-0-12-396971-2.00006-3 · 3.11 Impact Factor