Melatonin Levels in Smith Magenis Syndrome (SMS)
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Purpose
The goal of this pilot project is to determine whether melatonin levels are disordered in patients with Smith-Magenis Syndrome (SMS) and whether melatonin treatment can correct abnormal circadian rhythms in SMS patients. In addition, the study investigates the effects of bright light in an elderly control population that exhibits low melatonin secretion.
| Condition | Intervention |
|---|---|
|
Chromosome Disorders |
Dietary Supplement: Melatonin Device: Enviro-light artificial light box |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Diagnostic |
| Official Title: | Melatonin Levels in Sleep-Disordered Smith-Magenis Syndrome: a Pilot Study |
- Circadian Phase Marker, as measured by the melatonin levels in serial salivary and/or plasma samples [ Time Frame: every 2-4 weeks throughout the entire study ] [ Designated as safety issue: No ]
- Polysomnography sleep disorder assessment [ Time Frame: 1 optional, 12-hour assessment towards the end of the study ] [ Designated as safety issue: No ]
- Wrist actigraph activity levels as a secondary indicator of circadian phase [ Time Frame: every 2-4 weeks throughout the entire study along with every Circadian Phase Marker assessment ] [ Designated as safety issue: No ]
| Enrollment: | 5 |
| Study Start Date: | September 1998 |
| Study Completion Date: | May 2009 |
| Primary Completion Date: | March 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 2
Subjects will sit in front of a fluorescent bright light box while completing plasma samples to test for melatonin suppression in blood. This will be completed by both the SMS patient group and the control group of elderly individuals.
|
Device: Enviro-light artificial light box
Subjects will sit in front of an artificial, fluorescent light box (10,000 lux) while completing 25-hours of hourly plasma samples. The light lux level will be well below that identified as safe by the FDA.
Other Name: bright light treatment
|
|
Experimental: 1
Subjects will take up to 3 mg of melatonin daily and will complete frequent (every 2-4 weeks) of saliva and/or plasma sampling to test for a change in the timing of the body clock in response to the melatonin.
|
Dietary Supplement: Melatonin
up to 3 mg, daily, for up to 1 year
|
Detailed Description:
Participation involves 5 stages for SMS patients. First, Subjects will complete 4 sessions of 25-hour salivary or plasma sampling, with the last sampling occurring in front of a bright light box. Second, subjects will enroll in the melatonin treatment phase, involving a daily dose (up to 3 mg) for up to one year, with frequent (every 2-4 weeks) of 25-hour salivary or plasma sampling. During this stage, the subject and/or caregiver may also be asked to wear an activity wrist monitor, complete a daily sleep diary and behavioral questionnaires. Third, the subject may be asked to complete up to 3 25-hour sampling periods and take a melatonin pill on the same day to test how their body metabolizes the hormone, melatonin. The fourth stage is for subjects who are found to have an abnormal body rhythm. Subjects will complete a 25-hour plasma sampling period under bedrest to test for a hormone, Cortisol. The fifth stage is an optional 12-hour sleep analysis (polysomnography) to test for sleep disorders.
Control participants will complete an abbreviated protocol of the 3 baseline 25-hour sampling periods and 1 involving bright light exposure.
Eligibility| Ages Eligible for Study: | 3 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Control participants:
- 30 individuals: ages 55-85,
- healthy without significant active medical problems.
SMS patients:
- 20 individuals: ages 3-50,
- with a clinical diagnosis of Smith-Magenis Syndrome by a qualified Medical Geneticist, confirmed by cytogenetic analysis documenting deletion of chromosome band 17p11.2.
Exclusion Criteria:
Control participants:
- A current Axis I psychiatric or substance abuse disorder according to the DSM-IV Manual, abnormal heart, liver or kidney function, diagnoses of neurodegenerative or cerebrovascular disease (Alzheimer's disease, Parkinson's disease, stroke, etc.),
- cognitive impairment (Mini-Mental State Score < 23) but without a formal diagnosis of dementia,
- active symptoms of depression (Geriatric Depression Scale: 30 pt. version > 10),
- current diagnosis of cataracts,
- macular degeneration or retinopathy based on eye exam by an optometrist or ophthalmologist within the past year.
Contacts and Locations| United States, Oregon | |
| Sleep and Mood Disorders Lab, Oregon Health & Science University | |
| Portland, Oregon, United States, 97239 | |
| Principal Investigator: | Eilis Boudreau, MD | Oregon Health and Science University |
More Information
Publications:
| Responsible Party: | Alfred J. Lewy, MD, PhD / Senior Vice Chairman, Department of Psychiatry, Oregon Health & Science University |
| ClinicalTrials.gov Identifier: | NCT00691574 History of Changes |
| Other Study ID Numbers: | eIRB 0668, n/a unfunded |
| Study First Received: | May 30, 2008 |
| Last Updated: | June 17, 2009 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Oregon Health and Science University:
|
Smith-Magenis Syndrome melatonin circadian rhythm sleep |
Additional relevant MeSH terms:
|
Chromosome Disorders Chromosome Aberrations Smith-Magenis Syndrome Congenital Abnormalities Genetic Diseases, Inborn Pathologic Processes Chronobiology Disorders Nervous System Diseases Abnormalities, Multiple |
Melatonin Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Antioxidants Molecular Mechanisms of Pharmacological Action Protective Agents |
ClinicalTrials.gov processed this record on May 19, 2013