Interictal and postictal circadian and ultradian luteinizing hormone secretion in men with temporal lobe epilepsy.
OBJECTIVE
Hypothalamic regulation of the reproductive axis in temporal lobe epilepsy (TLE), represented by the ultradian pulsatile secretion of luteinizing hormone (LH), has been shown to be altered interictally and postictally. Our objective is to determine if epilepsy or seizures disrupt normal circadian fluctuations of LH as well as circadian organization of ultradian bursts of LH.


METHODS
We characterized LH secretion in 10 men with TLE during two 24-h blocks: an interictal epoch and a postictal epoch initiated by a seizure. Serum LH was measured every 10 min and characterized by circadian and ultradian patterns with cosinor and deconvolution analysis.


RESULTS
Mean peak serum concentrations of LH occurred at approximately 0400 in controls, were significantly delayed approximately 5 h interictally, and were randomly distributed postictally. Burst amplitudes differed significantly by phase among controls, with the largest amplitudes between 0101 and 0700 and the smallest between 1301 and 1900. No phase differences were present in interictal or postictal epochs. Burst frequency weakly but significantly was slowest between 0101 and 0700 in controls, but did not differ significantly by phase in either interictal or postictal epochs. Postictal LH burst frequencies, but not amplitudes, were significantly decreased immediately postictally.


CONCLUSIONS
The pulsatile secretion of LH in TLE is abnormal both in the circadian as well as the ultradian domain. Interictal effects consist mainly in loss of circadian fluctuations in LH burst amplitude, whereas postictal effects consist of altered burst timing. Altered daily patterns of neuroendocrine signals may underlie other disorders of homeostasis in TLE.
Quigg
Mark
M
Department of Neurology, University of Virginia, Charlottesville, VA 22908, USA. quigg@virginia.edu
Kiely
James M
JM
Johnson
Michael L
ML
Straume
Martin
M
Bertram
Edward H
EH
Evans
William S
WS
D000204:Activity Cycles / Q000502:physiology*; D000328:Adult; D016009:Chi-Square Distribution; D002940:Circadian Rhythm / Q000502:physiology*; D004833:Epilepsy, Temporal Lobe / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007031:Hypothalamus / Q000378:metabolism / Q000503:physiopathology; D016018:Least-Squares Analysis; D007986:Luteinizing Hormone / Q000097:blood / Q000378:metabolism* / Q000502:physiology; D008297:Male; D012636:Secretory Rate / Q000502:physiology; D012737:Sex Factors
D007986:Luteinizing Hormone