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Am J Physiol Regul Integr Comp Physiol 274: R991-R996, 1998;
0363-6119/98 $5.00
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Vol. 274, Issue 4, R991-R996, April 1998

Nonphotic entrainment of the human circadian pacemaker

Elizabeth B. Klerman1, David W. Rimmer1, Derk-Jan Dijk1, Richard E. Kronauer2, Joseph F. Rizzo III3, and Charles A. Czeisler1

1 Circadian, Neuroendocrine and Sleep Disorders Section, Endocrinology-Hypertension Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston 02115; 2 Division of Applied Sciences, Harvard University, Cambridge 02138; and 3 Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114

In organisms as diverse as single-celled algae and humans, light is the primary stimulus mediating entrainment of the circadian biological clock. Reports that some totally blind individuals appear entrained to the 24-h day have suggested that nonphotic stimuli may also be effective circadian synchronizers in humans, although the nonphotic stimuli are probably comparatively weak synchronizers, because the circadian rhythms of many totally blind individuals "free run" even when they maintain a 24-h activity-rest schedule. To investigate entrainment by nonphotic synchronizers, we studied the endogenous circadian melatonin and core body temperature rhythms of 15 totally blind subjects who lacked conscious light perception and exhibited no suppression of plasma melatonin in response to ocular bright-light exposure. Nine of these fifteen blind individuals were able to maintain synchronization to the 24-h day, albeit often at an atypical phase angle of entrainment. Nonphotic stimuli also synchronized the endogenous circadian rhythms of a totally blind individual to a non-24-h schedule while living in constant near darkness. We conclude that nonphotic stimuli can entrain the human circadian pacemaker in some individuals lacking ocular circadian photoreception.

activity; circadian rhythms; light; blindness


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