Nov. 5, 2013

Researchers study melatonin as a treatment for concussion in teenagers

Head injuries may disrupt production of sleep-regulating hormone
Karen Barlow, associate professor in the departments of pediatrics and clinical neurosciences, is leading the study of melatonin as a treatment for mild concussions in teenagers.

Karen Barlow is leading the study of melatonin as a treatment for mild concussions in teenagers.

Riley Brandt

Melatonin is taken by some people to help get a good night’s sleep. But now, researchers are interested in the hormone as a way to treat concussion.

A University of Calgary team is launching the first study in Canada to investigate the effects of melatonin on the brain activity of teenage patients suffering from a mild concussion.

Dr. Karen Barlow is leading the study. She is an associate professor in the departments of pediatrics and clinical neurosciences at the University of Calgary. She is also the director of the Traumatic Brain Injury and Rehabilitation Program at the Alberta Children’s Hospital and a member of the Alberta Children’s Hospital Research Institute

“If we can show that melatonin is a viable treatment for concussion, it would help many children improve the quality of their lives because right now there are so few therapies for treating post concussion symptoms,” says Dr. Barlow.

Headache is the most common symptom of concussion. In approximately 10 per cent of the population, chronic headache symptoms persist for more than three months after an injury. Other debilitating symptoms include impaired cognition, poor concentration, irritability, nausea and difficulty sleeping.

What is melatonin?

The researchers suspect melatonin production may be disrupted by a head injury. Melatonin is a hormone produced by the brain to regulate the sleep cycle.

“The brain appears to become hyper-excited after an injury and is more sensitive to lights, noise and smell,” says Barlow.  Studies on non-concussed adults suggest the hormone improves not only sleep, but also headaches and mood.

The five-year study funded by the Canadian Institute of Health Research is entitled ‘Play Game Trial, Post-Concussion Syndrome in Children and Youth, the GABAaergic effects of melatonin. The first part of the trial will be conducted at the Traumatic Brain Injury Clinic at the Alberta Children’s Hospital and the second trial will be conducted at the Children’s Hospital of Eastern Ontario.

Teenagers participating in study

One hundred Calgary teens are being enrolled in the study. They’ll be divided into three groups and randomly assigned either a low dose of melatonin, a high dose or a placebo. They’ll continue on the therapy for one month and will then be assessed on cognitive ability, neural activity and sleep quality.  Neural excitability and inhibition will be assessed using 3T MRI and diffusion imaging.

“What is novel about this study is that we are using new sophisticated techniques to see if we can understand both how melatonin works and how the brain recovers after an injury”, she says. “Every child enrolled in this study will contribute. We’ll see how the brain changes over time with or without melatonin. This study is going to provide us with a great deal of information about the neurobiology of a concussion.”

The study gets underway in early November.

Study information

The 2011 pilot study at the Alberta Children’s Hospital enrolled 19 participants, and found that melatonin was a more effective treatment for headache and migraines over the more potent and often prescribed drugs Amitriptyline, Topiramate, Flunarizine and Notryptiline. The research was published in April, 2013 in the journal Developmental Medicine & Neurology. 

“That research was interesting but there were too few participants in the trial to make any conclusions about melatonin,” she says.  “That is why we are expanding this study to a larger population and we’re using sophisticated technology to analyze the patient outcomes.”

For more information, contact research coordinator Brenda Turley at 403-955-3184 or Brenda.Turley@albertahealthservices.ca

Team of researchers

Preventing and treating concussion and brain injury is a priority under the Brain and Mental Health Strategic Research Theme. This theme is one of six research areas outlined in the University of Calgary’s Strategic Research Plan, which provides a roadmap to become one of Canada’s top five research universities. Over 200 researchers from nine faculties across campus are working together within this initiative to find innovative strategies for improved brain and mental health.

The  team of researchers from the University of Calgary include co-lead Deborah Dewey, Brian Brooks, Dr. Jeff Buchhalter, Susan Crawford, Dr. Michael Esser,  Dr. David Johnson, Dr. Michael Hill, Dr. Val Kirk, Dr. Adam Kirton, Frank MacMaster, Dr. Angelo Mikrogianakis, Alberto Nettel-Aguirre, and in Ottawa, Dr. Roger Zemek of CHEO.