STUDY OBJECTIVES The circadian system must perform daily adjustments to align sleep-wake and other physiologic rhythms with the environmental light-dark cycle: this is mediated primarily through melanopsin containing intrinsically photosensitive retinal ganglion cells. Individuals with delayed sleep-wake phase disorder (DSWPD) exhibit a delay in sleep-wake timing relative to the average population, while those with sighted non-24-hour sleep-wake rhythm disorder (N24SWD) exhibit progressive delays. An inability to maintain appropriate entrainment is characteristic of both disorders. In this study, we test the hypothesis that individuals with DSWPD exhibit alteration in melanopsin dependent retinal photo-transduction as measured with the post-illumination pupil response (PIPR). METHODS Twenty-one control and 29 participants with DSWPD were recruited from the community and clinic. Of the 29 DSWPD participants, 17 reported a history of N24SWD. A pupillometer was used to measure the post-illumination pupil response (PIPR) in response to a bright 30s blue or red-light stimulus. The PIPR was calculated as the difference in average pupil diameter at baseline and 10-40s after light stimulus offset. RESULTS The PIPR was significantly reduced in the DSWPD group when compared to the control group (1.26±1.11 mm vs. 2.05±1.04 mm, p&0.05, t-test). The PIPR was significantly reduced in the sighted N24SWD subgroup when compared to individuals with history of only DSWPD (0.88±0.58 mm vs 1.82±1.44 mm, p&0.05, ANOVA) or controls (0.88±0.58 mm vs 2.05±1.04 mm, p&0.01, ANOVA). CONCLUSIONS These results indicate that reduced melanopsin dependent retinal photo-transduction may be a novel mechanism involved in the development of DSWPD and sighted N24SWD.

中文翻译：

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黑视蛋白依赖性光转导在延迟性睡眠-觉醒阶段障碍和视力非 24 小时睡眠-觉醒节律障碍中受损

研究目标 昼夜节律系统必须进行日常调整，使睡眠-觉醒和其他生理节律与环境光-暗周期保持一致：这主要是通过含有内在光敏视网膜神经节细胞的黑视蛋白介导的。与普通人群相比，睡眠-觉醒延迟期障碍 (DSWPD) 的个体表现出睡眠-觉醒时间的延迟，而视力正常的非 24 小时睡眠-觉醒节律障碍 (N24SWD) 的个体表现出进行性延迟。无法保持适当的夹带是两种疾病的特征。在这项研究中，我们测试了以下假设：DSWPD 个体在黑视蛋白依赖性视网膜光转导中表现出改变，如用光照后瞳孔反应 (PIPR) 测量。方法 从社区和诊所招募了 21 名对照和 29 名 DSWPD 参与者。在 29 名 DSWPD 参与者中，17 名报告了 N24SWD 病史。瞳孔计用于测量照射后瞳孔反应 (PIPR)，以响应 30 秒的明亮蓝光或红光刺激。PIPR 计算为基线和光刺激偏移后 10-40 秒的平均瞳孔直径的差异。结果与对照组相比，DSWPD 组的 PIPR 显着降低（1.26±1.11 mm 与 2.05±1.04 mm，p&0.05，t 检验）。与仅有 DSWPD 病史的个体（0.88±0.58 mm vs 1.82±1.44 mm，p&0.05，方差分析）或对照组（0.88±0.58 mm vs 2.05±1.04 mm，p&0）相比，视力正常的 N24SWD 亚组的 PIPR 显着降低.01，方差分析）。