Artikel
Sleeping disturbance after pinealectomy in patients with pineocytoma WHO°I
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Autoren
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S. Krieg
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
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H. Slawik
- Schlafmedizinisches Zentrum der Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
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M. Wiegand
- Schlafmedizinisches Zentrum der Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
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B. Meyer
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
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M. Stoffel
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| Veröffentlicht: | 28. April 2011 |
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Gliederung
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Objective: The pineal gland is suggested to be involved in the regulation of sleep, especially because of its influence on REM sleep and circadian rhythm. Most likely, melatonin is the major mediator. However, immediate proof is still lacking. Tumors of the pineal gland are rare and vary widely in histology and malignancy. In this study, we examined 8 patients, who underwent pinealectomy between 2006 and 2010. We selected only patients with pineocytoma WHO°I who had no additional treatment that might have influenced sleep.
Methods: Standardized questionnaires were used, focusing on different parts of human sleep, such as Epworth Sleepiness Scale (ESS) for sleepiness during daytime, European diagnosis questionnaire, insomnia severity index (ISI) and Pittsburgh sleep quality index (PSQI). Moreover, as a control group, we used patients with benign intracranial lesions and patients without craniotomy, undergoing microscopic discectomy as matched pairs. Gender, age and date of operation where matched.
Results: Postoperatively, pinealectomy caused less sleepiness during daytime than craniotomy for benign supratentorial lesions or even than discectomy in ESS (6.38 ± 1.63 vs. 9.86 ± 2.18 and 10.25 ± 1.44 points). Furthermore, general sleep quality using PSQI was impaired in patients after craniotomy for benign supratentorial lesions (5.14 ±1.16 points) as well as after pinealectomy (5.88 ± 1.17 points) compared to patients after discectomy (2.75 ± 0.29 points).
Conclusions: We were neither able to find significant daytime sleepiness nor insomnia before and after pinealectomy. Moreover, we found more severe sleep impairment in patients, who had undergone other craniotomies or just discectomy, but with some contradictory results. Thus, more patients have to be included to investigate this matter and we plan to initiate a multicenter observational trial.
