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Published in: Acta Neurochirurgica 8/2012

01-08-2012 | Clinical Article

Sleep disturbance after pinealectomy in patients with pineocytoma WHO°I

Authors: Sandro M. Krieg, Helen Slawik, Bernhard Meyer, Michael Wiegand, Michael Stoffel

Published in: Acta Neurochirurgica | Issue 8/2012

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

Pinealectomy itself did not cause specific sleep impairment, but craniotomy in general did. This interesting and clinically relevant finding needs further investigation.
Literature
1.
go back to reference Barclay NL, Eley TC, Buysse DJ, Rijsdijk FV, Gregory AM (2010) Genetic and environmental influences on different components of the Pittsburgh sleep quality index and their overlap. Sleep 33:659–668PubMed Barclay NL, Eley TC, Buysse DJ, Rijsdijk FV, Gregory AM (2010) Genetic and environmental influences on different components of the Pittsburgh sleep quality index and their overlap. Sleep 33:659–668PubMed
2.
go back to reference Bastien CH, Vallieres A, Morin CM (2001) Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2:297–307PubMedCrossRef Bastien CH, Vallieres A, Morin CM (2001) Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2:297–307PubMedCrossRef
3.
go back to reference Bobbert AC, Riethoven JJ (1991) Feedback in the rabbit's central circadian system, revealed by the changes in its free-running food intake pattern induced by blinding, cervical sympathectomy, pinealectomy, and melatonin administration. J Biol Rhythms 6:263–278PubMedCrossRef Bobbert AC, Riethoven JJ (1991) Feedback in the rabbit's central circadian system, revealed by the changes in its free-running food intake pattern induced by blinding, cervical sympathectomy, pinealectomy, and melatonin administration. J Biol Rhythms 6:263–278PubMedCrossRef
4.
go back to reference Brat DJ, Parisi JE, Kleinschmidt-DeMasters BK, Yachnis AT, Montine TJ, Boyer PJ, Powell SZ, Prayson RA, McLendon RE (2008) Surgical neuropathology update: a review of changes introduced by the WHO classification of tumours of the central nervous system, 4th edition. Arch Pathol Lab Med 132:993–1007PubMed Brat DJ, Parisi JE, Kleinschmidt-DeMasters BK, Yachnis AT, Montine TJ, Boyer PJ, Powell SZ, Prayson RA, McLendon RE (2008) Surgical neuropathology update: a review of changes introduced by the WHO classification of tumours of the central nervous system, 4th edition. Arch Pathol Lab Med 132:993–1007PubMed
5.
go back to reference Brown EN, Choe Y, Shanahan TL, Czeisler CA (1997) A mathematical model of diurnal variations in human plasma melatonin levels. Am J Physiol 272:E506–E516PubMed Brown EN, Choe Y, Shanahan TL, Czeisler CA (1997) A mathematical model of diurnal variations in human plasma melatonin levels. Am J Physiol 272:E506–E516PubMed
6.
go back to reference Buysse DJ, Hall ML, Strollo PJ, Kamarck TW, Owens J, Lee L, Reis SE, Matthews KA (2008) Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample. J Clin Sleep Med 4:563–571PubMed Buysse DJ, Hall ML, Strollo PJ, Kamarck TW, Owens J, Lee L, Reis SE, Matthews KA (2008) Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample. J Clin Sleep Med 4:563–571PubMed
7.
go back to reference Buysse DJ, Reynolds CF 3rd, Kupfer DJ, Thorpy MJ, Bixler E, Manfredi R, Kales A, Vgontzas A, Stepanski E, Roth T et al (1994) Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial. Sleep 17:630–637PubMed Buysse DJ, Reynolds CF 3rd, Kupfer DJ, Thorpy MJ, Bixler E, Manfredi R, Kales A, Vgontzas A, Stepanski E, Roth T et al (1994) Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial. Sleep 17:630–637PubMed
8.
go back to reference Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatr Res 28:193–213CrossRef Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatr Res 28:193–213CrossRef
9.
go back to reference Buysse DJ, Reynolds CF 3rd, Monk TH, Hoch CC, Yeager AL, Kupfer DJ (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14:331–338PubMed Buysse DJ, Reynolds CF 3rd, Monk TH, Hoch CC, Yeager AL, Kupfer DJ (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14:331–338PubMed
10.
go back to reference Cardinali DP, Cutrera RA, Bonacho MG, Esquifino AI (1997) Effect of pinealectomy, superior cervical ganglionectomy, or melatonin treatment on 24-hour rhythms in ornithine decarboxylase and tyrosine hydroxylase activities of rat spleen. J Pineal Res 22:210–220PubMedCrossRef Cardinali DP, Cutrera RA, Bonacho MG, Esquifino AI (1997) Effect of pinealectomy, superior cervical ganglionectomy, or melatonin treatment on 24-hour rhythms in ornithine decarboxylase and tyrosine hydroxylase activities of rat spleen. J Pineal Res 22:210–220PubMedCrossRef
11.
go back to reference Chung KF, Kan KK, Yeung WF (2011) Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index. Sleep Med 12:463–470PubMedCrossRef Chung KF, Kan KK, Yeung WF (2011) Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index. Sleep Med 12:463–470PubMedCrossRef
12.
go back to reference Culebras A (1992) Neuroanatomic and neurologic correlates of sleep disturbances. Neurology 42:19–27PubMedCrossRef Culebras A (1992) Neuroanatomic and neurologic correlates of sleep disturbances. Neurology 42:19–27PubMedCrossRef
13.
go back to reference Desai KI, Nadkarni TD, Fattepurkar SC, Goel AH (2006) Pineal epidermoid cysts: a study of 24 cases. Surg Neurol 65:124–129PubMedCrossRef Desai KI, Nadkarni TD, Fattepurkar SC, Goel AH (2006) Pineal epidermoid cysts: a study of 24 cases. Surg Neurol 65:124–129PubMedCrossRef
14.
go back to reference Etzioni A, Luboshitzky R, Tiosano D, Ben-Harush M, Goldsher D, Lavie P (1996) Melatonin replacement corrects sleep disturbances in a child with pineal tumor. Neurology 46:261–263PubMedCrossRef Etzioni A, Luboshitzky R, Tiosano D, Ben-Harush M, Goldsher D, Lavie P (1996) Melatonin replacement corrects sleep disturbances in a child with pineal tumor. Neurology 46:261–263PubMedCrossRef
15.
go back to reference Fox SW, Lyon D, Farace E (2007) Symptom clusters in patients with high-grade glioma. J Nurs Scholarsh 39:61–67PubMedCrossRef Fox SW, Lyon D, Farace E (2007) Symptom clusters in patients with high-grade glioma. J Nurs Scholarsh 39:61–67PubMedCrossRef
16.
go back to reference Gustafsson M, Edvardsson T, Ahlstrom G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Canc 14:1205–1212CrossRef Gustafsson M, Edvardsson T, Ahlstrom G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Canc 14:1205–1212CrossRef
17.
go back to reference Jan JE, Tai J, Hahn G, Rothstein RR (2001) Melatonin replacement therapy in a child with a pineal tumor. J Child Neurol 16:139–140PubMed Jan JE, Tai J, Hahn G, Rothstein RR (2001) Melatonin replacement therapy in a child with a pineal tumor. J Child Neurol 16:139–140PubMed
18.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed
19.
go back to reference Johns MW (1992) Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 15:376–381PubMed Johns MW (1992) Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 15:376–381PubMed
20.
go back to reference Kang JK, Jeun SS, Hong YK, Park CK, Son BC, Lee IW, Kim MC (1998) Experience with pineal region tumors. Childs Nerv Syst 14:63–68PubMedCrossRef Kang JK, Jeun SS, Hong YK, Park CK, Son BC, Lee IW, Kim MC (1998) Experience with pineal region tumors. Childs Nerv Syst 14:63–68PubMedCrossRef
21.
go back to reference Karasek M, Winczyk K (2006) Melatonin in humans. J Physiol Pharmacol 57(Suppl 5):19–39PubMed Karasek M, Winczyk K (2006) Melatonin in humans. J Physiol Pharmacol 57(Suppl 5):19–39PubMed
22.
go back to reference Konovalov AN, Spallone A, Pitzkhelauri DI (1999) Pineal epidermoid cysts: diagnosis and management. J Neurosurg 91:370–374PubMedCrossRef Konovalov AN, Spallone A, Pitzkhelauri DI (1999) Pineal epidermoid cysts: diagnosis and management. J Neurosurg 91:370–374PubMedCrossRef
23.
go back to reference Leston J, Mottolese C, Champier J, Jouvet A, Brun J, Sindou M, Chazot G, Claustrat B, Fevre-Montange M (2009) Contribution of the daily melatonin profile to diagnosis of tumors of the pineal region. J Neurooncol 93:387–394PubMedCrossRef Leston J, Mottolese C, Champier J, Jouvet A, Brun J, Sindou M, Chazot G, Claustrat B, Fevre-Montange M (2009) Contribution of the daily melatonin profile to diagnosis of tumors of the pineal region. J Neurooncol 93:387–394PubMedCrossRef
24.
go back to reference Lipton J, Megerian JT, Kothare SV, Cho YJ, Shanahan T, Chart H, Ferber R, Adler-Golden L, Cohen LE, Czeisler CA, Pomeroy SL (2009) Melatonin deficiency and disrupted circadian rhythms in pediatric survivors of craniopharyngioma. Neurology 73:323–325PubMedCrossRef Lipton J, Megerian JT, Kothare SV, Cho YJ, Shanahan T, Chart H, Ferber R, Adler-Golden L, Cohen LE, Czeisler CA, Pomeroy SL (2009) Melatonin deficiency and disrupted circadian rhythms in pediatric survivors of craniopharyngioma. Neurology 73:323–325PubMedCrossRef
25.
go back to reference Morgan JT, Scumpia AJ, Webster TM, Mittler MA, Edelman M, Schneider SJ (2008) Resting tremor secondary to a pineal cyst: case report and review of the literature. Pediatr Neurosurg 44:234–238PubMedCrossRef Morgan JT, Scumpia AJ, Webster TM, Mittler MA, Edelman M, Schneider SJ (2008) Resting tremor secondary to a pineal cyst: case report and review of the literature. Pediatr Neurosurg 44:234–238PubMedCrossRef
26.
go back to reference Murata J, Sawamura Y, Ikeda J, Hashimoto S, Honma K (1998) Twenty-four hour rhythm of melatonin in patients with a history of pineal and/or hypothalamo-neurohypophyseal germinoma. J Pineal Res 25:159–166PubMedCrossRef Murata J, Sawamura Y, Ikeda J, Hashimoto S, Honma K (1998) Twenty-four hour rhythm of melatonin in patients with a history of pineal and/or hypothalamo-neurohypophyseal germinoma. J Pineal Res 25:159–166PubMedCrossRef
27.
go back to reference Neuwelt EA, Glasberg M, Frenkel E, Clark WK (1979) Malignant pineal region tumors. A clinico-pathological study. J Neurosurg 51:597–607PubMedCrossRef Neuwelt EA, Glasberg M, Frenkel E, Clark WK (1979) Malignant pineal region tumors. A clinico-pathological study. J Neurosurg 51:597–607PubMedCrossRef
28.
go back to reference Ogami S (1973) Change of delta activity during rapid eye movement sleep in patients with brain tumor. Electroencephalogr Clin Neurophysiol 34:153–162PubMedCrossRef Ogami S (1973) Change of delta activity during rapid eye movement sleep in patients with brain tumor. Electroencephalogr Clin Neurophysiol 34:153–162PubMedCrossRef
29.
go back to reference Packer RJ, MacDonald T, Vezina G (2008) Central nervous system tumors. Pediatr Clin North Am 55:121–145, xiPubMedCrossRef Packer RJ, MacDonald T, Vezina G (2008) Central nervous system tumors. Pediatr Clin North Am 55:121–145, xiPubMedCrossRef
30.
go back to reference Pandi-Perumal SR, Srinivasan V, Spence DW, Cardinali DP (2007) Role of the melatonin system in the control of sleep: therapeutic implications. CNS Drugs 21:995–1018PubMedCrossRef Pandi-Perumal SR, Srinivasan V, Spence DW, Cardinali DP (2007) Role of the melatonin system in the control of sleep: therapeutic implications. CNS Drugs 21:995–1018PubMedCrossRef
31.
go back to reference Petterborg LJ, Thalen BE, Kjellman BF, Wetterberg L (1991) Effect of melatonin replacement on serum hormone rhythms in a patient lacking endogenous melatonin. Brain Res Bull 27:181–185PubMedCrossRef Petterborg LJ, Thalen BE, Kjellman BF, Wetterberg L (1991) Effect of melatonin replacement on serum hormone rhythms in a patient lacking endogenous melatonin. Brain Res Bull 27:181–185PubMedCrossRef
32.
go back to reference Reiter RJ (1991) Pineal melatonin: cell biology of its synthesis and of its physiological interactions. Endocr Rev 12:151–180PubMedCrossRef Reiter RJ (1991) Pineal melatonin: cell biology of its synthesis and of its physiological interactions. Endocr Rev 12:151–180PubMedCrossRef
33.
go back to reference Skene DJ, Arendt J (2006) Human circadian rhythms: physiological and therapeutic relevance of light and melatonin. Ann Clin Biochem 43:344–353PubMedCrossRef Skene DJ, Arendt J (2006) Human circadian rhythms: physiological and therapeutic relevance of light and melatonin. Ann Clin Biochem 43:344–353PubMedCrossRef
34.
go back to reference Szucs A, Bodizs R, Barsi P, Halasz P (2001) Insomnia and fronto-basal tumor: a case report. Eur Neurol 46:54–56PubMedCrossRef Szucs A, Bodizs R, Barsi P, Halasz P (2001) Insomnia and fronto-basal tumor: a case report. Eur Neurol 46:54–56PubMedCrossRef
35.
go back to reference Taphoorn MJ, Heimans JJ, Snoek FJ, Lindeboom J, Karim AB (1994) Quality of life and neuropsychological functions in long-term low-grade glioma survivors. Int J Radiat Oncol Biol Phys 29:1201–1202PubMedCrossRef Taphoorn MJ, Heimans JJ, Snoek FJ, Lindeboom J, Karim AB (1994) Quality of life and neuropsychological functions in long-term low-grade glioma survivors. Int J Radiat Oncol Biol Phys 29:1201–1202PubMedCrossRef
36.
go back to reference Taphoorn MJ, Heimans JJ, Snoek FJ, Lindeboom J, Oosterink B, Wolbers JG, Karim AB (1992) Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. J Neurol Neurosurg Psychiatry 55:372–376PubMedCrossRef Taphoorn MJ, Heimans JJ, Snoek FJ, Lindeboom J, Oosterink B, Wolbers JG, Karim AB (1992) Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. J Neurol Neurosurg Psychiatry 55:372–376PubMedCrossRef
37.
go back to reference Ulas UH, Korkmaz A, Karadas O, Odabasi Z, Reiter RJ (2010) Sunrise-related headache: case report. Cephalalgia 30:118–122PubMed Ulas UH, Korkmaz A, Karadas O, Odabasi Z, Reiter RJ (2010) Sunrise-related headache: case report. Cephalalgia 30:118–122PubMed
38.
go back to reference Vijayalaxmi, Thomas CR Jr, Reiter RJ, Herman TS (2002) Melatonin: from basic research to cancer treatment clinics. J Clin Oncol 20:2575–2601PubMedCrossRef Vijayalaxmi, Thomas CR Jr, Reiter RJ, Herman TS (2002) Melatonin: from basic research to cancer treatment clinics. J Clin Oncol 20:2575–2601PubMedCrossRef
39.
go back to reference Vorkapic P, Waldhauser F, Bruckner R, Biegelmayer C, Schmidbauer M, Pendl G (1987) Serum melatonin levels: a new neurodiagnostic tool in pineal region tumors? Neurosurgery 21:817–824PubMedCrossRef Vorkapic P, Waldhauser F, Bruckner R, Biegelmayer C, Schmidbauer M, Pendl G (1987) Serum melatonin levels: a new neurodiagnostic tool in pineal region tumors? Neurosurgery 21:817–824PubMedCrossRef
40.
go back to reference Yamakawa K, Shitara N, Genka S, Manaka S, Takakura K (1989) Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors. Neurosurgery 24:568–573PubMedCrossRef Yamakawa K, Shitara N, Genka S, Manaka S, Takakura K (1989) Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors. Neurosurgery 24:568–573PubMedCrossRef
Metadata
Title
Sleep disturbance after pinealectomy in patients with pineocytoma WHO°I
Authors
Sandro M. Krieg
Helen Slawik
Bernhard Meyer
Michael Wiegand
Michael Stoffel
Publication date
01-08-2012
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 8/2012
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-012-1409-y

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