Objective: Our aim was to compare hypothalamic volumes in PD patients with matched controls, and determine whether volume loss correlated with reduced melatonin output in the PD group.

Background: Recent studies have suggested that melatonin – a hormone produced by the pineal gland under circadian control – contributes to PD-related sleep dysfunction. We hypothesised that degenerative changes to the neural structures controlling pineal function (especially the suprachiasmatic nuclei of the anterior hypothalamus) may be responsible for reduced melatonin output in these patients.

Methods: 12 PD patients and 12 matched controls underwent magnetic resonance imaging to determine hypothalamic volume. In addition, PD patients underwent 24-hour blood sampling in a controlled environment to determine serum melatonin concentrations using enzyme-linked immunosorbent assays.

Results: PD patients had significantly reduced hypothalamic grey matter volume compared to matched controls (p=0.005). Melatonin levels were significantly associated with hypothalamic grey matter volume and disease severity in PD patients (p=0.028). Partial correlation between melatonin levels and disease severity, corrected for LED, showed a significant inverse relationship (r=-0.681, p=0.021).

Conclusions: Melatonin levels are associated with hypothalamic grey matter volume loss and disease severity in PD patients. This provides anatomical and physiological support for an intrinsic sleep and circadian phenotype in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hypothalamic-volume-loss-is-associated-with-reduced-melatonin-output-in-parkinsons-disease/