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May 1983

Absence of Sleep-Related Elevation of Growth Hormone Level in Patients With Stroke

Author Affiliations

From the Departments of Neurology (Dr Culebras) and Medicine (Dr Miller), State University of New York Upstate Medical Center; and the Veterans Administration Medical Center (Drs Culebras and Miller), Syracuse, NY.

Arch Neurol. 1983;40(5):283-286. doi:10.1001/archneur.1983.04050050051006

• To determine the effect of defined suprahypothalamic lesions on sleep-related growth hormone (GH) secretion, eight patients with hemispheric lesions of vascular origin were studied in a sleep laboratory on two consecutive nights. Despite the normal onset and increased time spent in slow-wave sleep (SWS), the patients failed to show the nocturnal rise in plasma GH concentration that occurred in association with onset of SWS in five age-matched healthy subjects. Arginine hydrochloride infusion in the patients produced a normal GH rise, indicating integrity of the hypothalamic-pituitary axis. Dissociation between SWS and GH secretion in patients with suprahypothalamic damage suggests that cortical-subcortical structures are involved in the integration of SWS with nocturnal GH secretion. There is support for the presence of a thalamic regulatory center responsible for the control of GH release during sleep.