Systematic review of melatonin levels in individuals with complete cervical spinal cord injury

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#adult #cervical-cord #circadian-rhythm #humans #melatonin

Systematic review of melatonin levels in individuals with complete cervical spinal cord injury

Whelan et al., 2020 | J Spinal Cord Med | Systematic Review

Citation

Whelan Alexander, Halpine Mary, ... McVeigh Sonja A. Systematic review of melatonin levels in individuals with complete cervical spinal cord injury. J Spinal Cord Med. 2020-Sep;43(5):565-578. doi:10.1080/10790268.2018.1505312

Abstract

Context: Pineal melatonin production is mediated by afferent signaling pathways that navigate through the cervicothoracic spinal cord. Melatonin profiles in individuals with complete cervical spinal cord injury (SCI) have not been systematically reviewed despite this proposed pathway. Objectives: The primary objective was to understand melatonin profiles in individuals with complete cervical SCI, as compared to healthy controls and those with thoracolumbar and incomplete cervical SCI. Secondary objectives were to understand the impact of injury chronicity and melatonin supplementation on melatonin values in adults with complete cervical SCI. Methods: This review (PROSPERO ID: CRD42017073767) searched several databases and gray literature sources from January 1978 to August 2017. Studies were eligible if they evaluated melatonin levels (blood, saliva or urinary metabolite measurements) in adults with complete cervical SCI. 390 studies were screened and 12 studies met final selection criteria. Given the heterogeneity in study designs, a narrative analysis was performed. Results: There is evidence that adults with complete cervical SCI have absent diurnal melatonin rhythms as compared to healthy controls and individuals with thoracolumbar SCI below T3. There is limited evidence comparing levels in individuals with incomplete tetraplegia. There is insufficient evidence describing profiles immediately (<2 weeks) after cervical SCI. Based on a limited number of studies, melatonin supplementation does not appear to improve sleep outcomes in adults with long-standing complete cervical SCI. Conclusions: Future research should explore melatonin levels acutely after cervical SCI and the impact of supplementation on non-sleep outcomes.

Key Findings

There is evidence that adults with complete cervical SCI have absent diurnal melatonin rhythms as compared to healthy controls and individuals with thoracolumbar SCI below T3. There is limited evidence comparing levels in individuals with incomplete tetraplegia. There is insufficient evidence describing profiles immediately (<2 weeks) after cervical SCI. Based on a limited number of studies, melatonin supplementation does not appear to improve sleep outcomes in adults with long-standing complete

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population complete cervical spinal cord
Sample Size 390
Age Range See abstract
Condition sleep

MeSH Terms

  • Adult
  • Cervical Cord
  • Circadian Rhythm
  • Humans
  • Melatonin
  • Spinal Cord Injuries

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09