Pharmacopsychiatry 2002; 35(4): 135-143
DOI: 10.1055/s-2002-33195
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Oral Mg2+ Supplementation Reverses Age-Related Neuroendocrine and Sleep EEG Changes in Humans

K. Held1 , I. A. Antonijevic1 , H. Künzel1 , M. Uhr1 , T. C. Wetter1 , I. C. Golly2 , A. Steiger1 , H. Murck1
  • 1Max Planck Institute of Psychiatry, Munich, Germany
  • 2Institute of Pharmacology and Toxicology, LMU, Munich, Germany
The study was supported by Hermes Arzneimittel GmbH, Großhesselohe/Munich
Further Information

Publication History

Manuscript received: 2. 5. 2001 Revised: 13. 7. 2001

Accepted: 30. 10. 2001

Publication Date:
06 August 2002 (online)

Introduction

The process of normal ageing is characterised by changes of CNS function leading to alteration of the sleep electroencephalogram (EEG) and hormone secretion. In the elderly, a decline in sleep continuity, a shortening of rapid eye movement (REM) latency, a decrease in slow wave sleep (SWS) and an increase in nocturnal wakefulness are detectable [9] [28] [65]. Beside these changes, a loss of the sleep dependent increase in spindle incidence and duration has been demonstrated in elderly [51].

In addition, ageing is accompanied by a disinhibition of HPA system activity in both experimental animals [35] and humans [38] [84]. Another altered endocrine system in the course of ageing is the renin-angiotensin-aldosterone system (RAAS). An age-related decrease in plasma renin activity has been demonstrated in normotensive human subjects [22] [60] [71] [83] [86] accompanied by a tendency for a reduced aldosterone concentration [32]. Similarly, a reduced activity of the RAAS in experimental animals has been shown in aged compared to young animals [21] [36].

There is a close association between sleep architecture, especially SWS, and the activity of the glutamatergic and GABAergic system. An increase in SWS in rats was observed after intrathalamic administration of the NMDA antagonist DL-2-amino-5-phosphono-pentanoic acid (APV) [46] and after the intraperitoneal injection of NMDA antagonist MK-801 [16]. Also, the GABAA agonists THIP (gaboxadol) increased delta activity in rats [49] [50] and SWS in young healthy controls [27] and in elderly humans [55]. An earlier study from our group on the effects of i. v. Mg2+ on the sleep EEG and nocturnal hormone secretion pointed to an NMDA-antagonistic and a GABA-agonistic efficacy of Mg2+ [59], an assumption well in line with preclinical studies [40] [61] [72] [73] [78].

Direct evidence for a disturbance of the glutamatergic neurotransmission in ageing was given by preclinical studies in mice demonstrating a reduced reuptake of glutamate in aged compared to younger animals [70]. The resulting glutamatergic overactivity might secondarily result in the age-related declines of NMDA receptors, as has been reported in rodents [20] [80]. This is of interest since a decrease in NMDA binding sites has been correlated with a declining performance of memory-associated tasks [63].

Also, the changes in the sleep EEG occurring during ageing bear some similarities to those in Mg2+ deficiency. Mg2+ deficits lead to sleep disturbances with increased wakefulness at the expense of SWS [23] or a predominance of active waking and a decrease in total sleep time [64] in rats. On the other hand, there have also been reports on a sleep-stabilising effect of Mg2+. Intravenous (i. v.) administration of Mg2+ before surgery led to a significantly better quality of sleep in a double blind trial on surgical patients [81].

Besides its modulatory influence on glutamatergic and GABAergic neurotransmission, Mg2+ also has an angiotensin II (ATII)-antagonistic effect [4] [43], and is able to influence the HPA system [59]. The combination of these properties of Mg2+ influencing systems involved in the process of ageing and reports on its sleep stabilising effect led us to perform a study on the effect of oral Mg2+ supplementation on the sleep EEG and the nocturnal hormone secretion.

References

  • 1 Aeschbach D, Dijk D J, Trachsel L, Brunner D P, Borbely A A. Dynamics of slow-wave activity and spindle frequency activity in the human sleep EEG: effect of midazolam and zopiclone.  Neuropsychopharmacology. 1994;  11 237-244
  • 2 Antonijevic I A, Murck H, Frieboes R M, Schier T, Holsboer F, Steiger A. Hyporesponsiveness of the pituitary to CRH during slow wave sleep is not mimicked by systemic GHRH.  Neuroendocrinology. 1999;  69 88-96
  • 3 Atarashi K, Matsuoka H, Takagi M, Sugimoto T. Magnesium ion: a possible physiological regulator of aldosterone production.  Life Sci.. 1989;  44 1483-1489
  • 4 Atarashi K, Takagi M, Matsuoka H, Sugimoto T. Effects of magnesium on changes in blood pressure and plasma aldosterone induced by angiotensin II.  Am. J.Hypertens.. 1990;  3 488-490
  • 5 Bader M, Ganten D. Regulation of renin:new evidence from cultured cells and genetically modified mice.  Journal of Moleculare Medicine. 2000;  78 130-139
  • 6 Bierwolf C, Struve K, Marshall L, Born J, Fehm H L. Slow wave sleep drives inhibition of pituitary-adrenal secretion in humans.  J.Neuroendocrinol.. 1997;  9 479-484
  • 7 Billiard M. Lithium carbonate: effects on sleep patterns of normal and depressed subjects and its use in sleep-wake pathology.  Pharmacopsychiatry. 1987;  20 195-196
  • 8 Bito L Z. Blood-brain barrier: evidence for active cation transport between blood and the extracellular fluid of brain.  Science. 1968;  165 81-83
  • 9 Bliwise D L. Sleep in normal aging and dementia.  Sleep. 1993;  16 40-81
  • 10 Bohlhalter S, Murck H, Holsboer F, Steiger A. Cortisol enhances non-REM sleep and growth hormone secretion in elderly subjects.  Neurobiol.Aging. 1997;  18 423-429
  • 11 Borella P, Giardino A, Neri M, Andermarker E. Magnesium and potassium status in elderly subjects with and without dementia of the Alzheimer type.  Magnesium Research. 1990;  3 283-289
  • 12 Born J, De Kloet E R, Wenz H, Kern W, Fehm H L. Gluco- and antimineralocorticoid effects on human sleep: a role of central corticosteroid receptors.  Am. J.Physiol.. 1991;  260 E183-188
  • 13 Born J, Steinbach D, Dodt C, Fehm H L. Blocking of central nervous mineralocorticoid receptors counteracts inhibition of pituitary-adrenal activity in human sleep.  J.Clin.Endocrinol.Metab.. 1997;  82 1106-1110
  • 14 Born J, Zwick A, Roth G, Fehm-Wolfsdorf G, Fehm H L. Differential effects of hydrocortisone, fluocortolone, and aldosterone on nocturnal sleep in humans.  Acta Endocrinol.(Copenh.). 1987;  116 129-137
  • 15 Brooks V L, Malvin R L. An intracerebral, physiological role for angiotensin: effects of central blockade.  Fed.Proc.. 1979;  38 2272-2275
  • 16 Campbell I G, Feinberg I. Noncompetitive NMDA channel blockade during waking intensely stimulates NREM delta.  J. Pharmacol. Exp. Ther.. 1996b;  276 737-742
  • 17 Campbell I G, Feinberg I. NREM delta stimulation following MK-801 is a response of sleep systems.  J.Neurophysiol.. 1996a;  76 3714-3720
  • 18 Chollet D, Franken P, Raffin Y, Malafosse A, Widmer J, Tafti M. Blood and brain magnesium in inbred mice and their correlation with sleep quality.  Am. J.Physiol.-Reg. I.. 2000;  279 R2173-2178
  • 19 Chouinard G, Beauclair L, Geiser R, Etienne P. A pilot study of magnesium aspartate hydrochloride (Magnesiocard) as a mood stabilizer for rapid cycling bipolar affective disorder patients.  Prog.Neuropsychopharmacol.Biol.Psychiatry. 1990;  14 171-180
  • 20 Clark A S, Magnusson K R, Cotman C W. In vitro autoradiography of hippocampal excitatory amino acid binding in aged Fischer 344 rats: relationship to performance on the Morris water maze.  Behav.Neurosci.. 1992;  106 324-335
  • 21 Corman B, Michel J B. Renin-angiotensin system, converting-enzyme inhibition and kidney function in aging female rats.  Am. J.Physiol.. 1986;  251 R450-455
  • 22 Crane M G, Harris J J. Effect of aging on renin activity and aldosterone excretion.  J.Lab.Clin.Med.. 1976;  87 947-959
  • 23 Depoortere H, Francon D, Llopis J. Effects of a magnesium-deficient diet on sleep organization in rats.  Neuropsychobiology. 1993;  27 237-245
  • 24 Ditzler K. Efficacy and tolerability of memantine in patients with dementia syndrome. A double-blind, placebo controlled trial.  Arzneimittelforschung. 1991;  41 773-780
  • 25 Facchinetti F, Borella P, Sances G, Fioroni L, Nappi R E, Genazzani A R. Oral magnesium successfully relieves premenstrual mood changes.  Obstet.Gynecol.. 1991;  78 177-181
  • 26 Farah J M Jr., Rao T S, Mick S J, Coyne K E, Iyengar S. N-methyl-D-aspartate treatment increases circulating adrenocorticotropin and luteinizing hormone in the rat.  Endocrinology. 1991;  128 1875-1880
  • 27 Faulhaber J, Steiger A, Lancel M. The GABAA agonist THIP produces slow wave sleep and reduces spindling activity in Non-REM sleep in humans.  Psychopharmacology. 1997;  130 285-291
  • 28 Feinberg I. Changes in sleep cycle patterns with age.  J.Psychiatr.Res.. 1974;  10 283-306
  • 29 Frankiewicz T, Parsons C G. Memantine restores long term potentiation impaired by tonic N-methyl-D-aspartate (NMDA) receptor activation following reduction of Mg2+ in hippocampal slices.  Neuropharmacology. 1999;  38 1253-1259
  • 30 Friess E, Tagaya H, Grethe C, Trachsel L, Holsboer F. Cortisol infusion increases EEG slow wave activity within non-REM sleep in humans.  J.Sleep Res.. 1996;  5 (Suppl. 1) 69
  • 31 Friston K J, Sharpley A L, Solomon R A, Cowen P J. Lithium increases slow wave sleep: possible mediation by brain 5-HT2 receptors?.  Psychopharmacology. 1989;  98 139-140
  • 32 Frolkis V V, Verkhratsky N S, Magdich L V. Regulation of aldosterone secretion in old rats.  Gerontology. 1985;  31 84-94
  • 33 Fuchs-Buder T, Tramer M R, Tassonyi E. Cerebrospinal fluid passage of intravenous magnesium sulfate in neurosurgical patients.  J Neurosurg Anesthesiol. 1997;  9 324-328
  • 34 Ganong W F. Blood, pituitary, and brain renin-angiotensin systems and regulation of secretion of anterior pituitary gland.  Front.Neuroendocrinol.. 1993;  14 233-249
  • 35 Hatzinger M, Reul J M, Landgraf R, Holsboer F, Neumann I. Combined dexamethasone/CRH test in rats: hypothalamo-pituitary- adrenocortical system alterations in aging.  Neuroendocrinology. 1996;  64 349-356
  • 36 Hayashi M, Saruta T, Nakamura R, Kitajima W, Kato E. Effect of aging on single nephron renin content in rats.  Renal Physiology. 1981;  4 17-21
  • 37 Heuser I, Deuschle M, Weber A, Kniest A, Ziegler C, eber B, olla M. The role of mineralocorticoid receptors in the circadian activity of the human hypothalamus-pituitary-adrenal system.  Neurobiol.Aging. 2000;  21 585-589
  • 38 Heuser I J, Gotthardt U, Schweiger U, Schmider J, Lammers C H, Dettling M, Holsboer F. Age-associated changes of pituitary-adrenocortical hormone regulation in humans: importance of gender.  Neurobiol. Aging. 1994;  15 227-231
  • 39 Hoch C C, Dew M A, Reynolds C F3, Monk T H, Buysse D J, Houck P R, Machen M A, Kupfer D J. A longitudinal study of laboratory- and diary-based sleep measures in healthy ”old old” and ”young old” volunteers.  Sleep. 1994;  17 489-496
  • 40 Horne A L, Harrison N L, Turner J P, Simmonds M A. Spontaneous paroxysmal activity induced by zero magnesium and bicuculline: suppression by NMDA antagonists and GABA mimetics.  Eur. J.Pharmacol.. 1986;  122 231-238
  • 41 Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D. Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study.  Sleep. 1998;  21 501-505
  • 42 Horton R, Biglieri E G. Effect of Aldosterone on the Metabolism of Magnesium.  J.Clin.Endocrinol.Metab.. 1962;  22 1187-1192
  • 43 Ichihara A, Suzuki H, Saruta T. Effects of magnesium on the renin-angiotensin-aldosterone system in human subjects.  J.Lab.Clin.Med.. 1993;  122 432-440
  • 44 Jezova D, Oliver C, Jurcovicova J. Stimulation of adrenocorticotropin but not prolactin and catecholamine release by N-methyl-aspartic acid.  Neuroendocrinology. 1991;  54 488-492
  • 45 Jezova D, Tokarev D, Rusnak M. Endogenous excitatory amino acids are involved in stress-induced adrenocorticotropin and catecholamine release.  Neuroendocrinology. 1995;  62 326-332
  • 46 Juhasz G, Kekesi K, Emri Z, Soltesz I, Crunelli V. Sleep-promoting action of excitatory amino acid antagonists: a different role for thalamic NMDA and non-NMDA receptors.  Neurosci.Lett.. 1990;  114 333-338
  • 47 Kniest A, Wiesenberg C, Weber B, Colla M, Heuser I J, Deuschle M. The Glutamate Antagonist Riluzole and Its Effects upon Basal and Stress-Induced Activity of the Human Hypothalamus- Pituitary-Adrenocortical System in Elderly Subjects.  Neuropsychobiology. 2001;  43 91-95
  • 48 Kupfer D J, Reynolds C F, Weiss B L, Foster F G. Lithium carbonate and sleep in affective disorders. Further considerations.  Arch Gen Psychiatry. 1974;  30 79-84
  • 49 Lancel M. The GABA(A) agonist THIP increases non-REM sleep and enhances non-REM sleep-specific delta activity in the rat during the dark period.  Sleep. 1997;  20 1099-1104
  • 50 Lancel M, Faulhaber J. The GABAA agonist THIP (gaboxadol) increases non-REM sleep and enhances delta activity in the rat.  NeuroReport. 1996;  7 2241-2245
  • 51 Landolt H P, Dijk D J, Achermann P, Borbély A A. Effect of age on the sleep EEG: slow-wave activity and spindle frequency activity in young and middle-aged men.  Brain Res.. 1996;  738 205-212
  • 52 Lauer C, Riemann D, Wiegand M, Berger M. From early to late adulthood. Changes in EEG sleep of depressed patients and healthy volunteers.  Biol.Psychiatry. 1991;  29 979-993
  • 53 Luthringer R, Brandenberger G, Schaltenbrand N, Muller G, Spiegel K, Macher J P, Muzet A, Follenius M. Slow wave electroencephalic activity parallels renin oscillations during sleep in humans.  Electroencephalogr.Clin.Neurophysiol.. 1995;  95 318-322
  • 54 Makino I, Shibata K, Shibaguchi H, Niwa M, Katsuragi T, Furukawa T. The increase in angiotensin type-2 receptor mRNA level by glutamate stimulation in cultured rat cortical cells.  Brain Res.. 1998;  804 296-305
  • 55 Mathias S, Wetter T C, Steiger A, Lancel M. The GABA uptake inhibitor tiagabine promotes slow wave sleep in normal elderly subjects.  Neurobiol.Aging. 2001;  22(2) 247-253
  • 56 Miguez I, Aldegunde M A. Effect of gamma-aminobutyric acid on corticosterone secretion: involvement of the noradrenergic system.  Life Sci.. 1990;  46 875-880
  • 57 Morris M E. Brain and CSF magnesium concentrations during magnesium deficit in animals and humans: neurological symptoms.  Magnes Res. 1992;  5 303-313
  • 58 Muller H F, Dastoor D P, Klingner A, Cole M, Boillat J. Amantadine in senile dementia: electroencephalographic and clinical effects.  J.Am.Geriatr.Soc.. 1979;  27 9-16
  • 59 Murck H, Steiger A. Mg2+ reduces ACTH secretion and enhances spindle power without changing delta power during sleep in men - possible therapeutical implications.  Psychopharmacology. 1998;  137 247-252
  • 60 Noth R H, Lassman M N, Tan S Y, Fernandez-Cruz A J, Mulrow P J. Age and the renin-aldosterone system.  Arch.Intern.Med.. 1977;  137 1414-1417
  • 61 Nowak L, Bregestovski P, Ascher P, Herbet A, Prochiantz A. Magnesium gates glutamate-activated channels in mouse central neurones.  Nature. 1984;  307 462-465
  • 62 Pavlinac D, Langer R, Lenhard L, Deftos L. Magnesium in affective disorders.  Biol.Psychiatry. 1979;  14 657-661
  • 63 Pelleymounter M A, Beatty G, Gallagher M. Hippocampal 3H-CPP binding and spatial learning deficits in aged rats.  Psychobiology 18 (3). 1929;  1990 298-304
  • 64 Poenaru S, Rouhani S, Durlach J, Aymard N, Belkahla F, Rayssiguier Y, Iovino M. Vigilance states and cerebral monoamine metabolism in experimental magnesium deficiency.  Magnesium. 1984;  3 145-151
  • 65 Prinz P N, Peskind E R, Vitaliano P P, Raskind M A, Eisdorfer C, Zemcuznikov N, Gerber C J. Changes in the sleep and waking EEGs of nondemented and demented elderly subjects.  J.Am.Geriatr.Soc.. 1982;  30 86-93
  • 66 Puca F M, Bricolo A, Turella G. Effect of L-dopa or amantadine therapy on sleep spindles in Parkinsonism.  Electroencephalogr.Clin.Neurophysiol.. 1973;  35 327-330
  • 67 Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. US Department of Health, Education & Welfare, Neurological Information Network Bethesda, MD; 1968
  • 68 Reynolds C F3, Kupfer D J, Taska L S, Hoch C C, Spiker D G, Sewitch D E, Zimmer B, Marin R S, Nelson J P, Martin D. et al . EEG sleep in elderly depressed, demented, and healthy subjects.  Biol.Psychiatry. 1985;  20 431-442
  • 69 Sailer M, Heinze H J, Schoenfeld M A, Hauser U, Smid H G. Amantadine influences cognitive processing in patients with multiple sclerosis.  Pharmacopsychiatry. 2000;  33 28-37
  • 70 Saransaari P, Oja S S. Age-related changes in the uptake and release of glutamate and aspartate in the mouse brain.  Mech.Ageing Develop.. 1995;  81 61-71
  • 71 Saruta T, Suzuki A, Hayashi M, Yasui T, Eguchi T, Kato E. Mechanism of age-related changes in renin and adrenocortical steroids.  J.Am.Geriatr.Soc.. 1980;  28 210-214
  • 72 Schneiderman J H, Arnold D, Advani A. Different changes in spontaneous field potential oscillations precede epileptiform bursting in hippocampal slices perfused with penicillin or reduced magnesium.  Brain Res.. 1990;  533 275-285
  • 73 Schwartz R D, Wagner J P, Yu X, Martin D. Bidirectional modulation of GABA-gated chloride channels by divalent cations: inhibition by Ca2+ and enhancement by Mg2+ .  J.Neurochem.. 1994;  62 916-922
  • 74 Shricker K, Holmer S, Kramer B K, Riegger G A, Kurtz A. The role of angiotensin II in the feedback control of renin gene expression.  Pflugers Archiv - European Journal of Physiology. 1997;  434 166-172
  • 75 Steiger A. Sleep and the hypothalamo-pituitary-adrenocortical-system. Sleep Medicine Reviews 2001; in press
  • 76 Steiger A, Rupprecht R, Spengler D, Guldner J, Hemmeter  U, Rothe B, Damm K, Holsboer F. Functional properties of deoxycorticosterone and spironolactone: molecular characterization and effects on sleep-endocrine activity.  J.Psychiatr.Res.. 1993;  27 275-284
  • 77 Stella A, Macchi A, Genovesi S, Centonza L, Zanchetti A. Angiotensin converting enzyme inhibition and renin release from the kidney.  Journal of Hypertension - Supplement. 1989;  7 S21-25
  • 78 Stevens D R, McCarley R W, Greene R W. Excitatory amino acid-mediated responses and synaptic potentials in medial pontine reticular formation neurons of the rat in vitro.  J.Neurosci.. 1992;  12 4188-4194
  • 79 Sumitomo T, Suda T, Nakano Y, Tozawa F, Yamada M, Demura H. Angiotensin II increases the corticotropin-releasing factor messenger ribonucleic acid level in the rat hypothalamus.  Endocrinology. 1991;  128 2248-2252
  • 80 Tamaru M, Yoneda Y, Ogita K, Shimizu J, Nagata Y. Age-related decreases of the N-methyl-D-aspartate receptor complex in the rat cerebral cortex and hippocampus.  Brain Res.. 1991;  542 83-90
  • 81 Tramer M R, Schneider J, Marti R A, Rifat K. Role of magnesium sulfate in postoperative analgesia.  Anesthesiology. 1996;  84 340-347
  • 82 Transbol I, Christiansen C, Baastrup P C, Nielsen M D, Giese J. Endocrine effects of lithium. III. Hypermagnesaemia and activation of the renin-aldosterone system.  Acta Endocrinol.. 1978;  88 619-624
  • 83 Tsunoda K, Abe K, Goto T, Yasujima M, Sato M, Omata K, Seino M, Yoshinaga K. Effect of age on the renin-angiotensin-aldosterone system in normal subjects: simultaneous measurement of active and inactive renin, renin substrate, and aldosterone in plasma.  J. Clin. Endocrinol. Metab.. 1986;  62 384-389
  • 84 Van Coevorden A, Mockel J, Laurent E, Kerkhofs M, L’Hermite-Balériaux M, Decoster C, Neve P, Van Cauter E. Neuroendocrine rhythms and sleep in aging men.  Am. J.Physiol.. 1991;  260 E651-661
  • 85 Veith R C, Raskind M A. The neurobiology of aging: does it predispose to depression?.  Neurobiol.Aging. 1988;  9 101-117
  • 86 Weidmann P, De Myttenaere-Bursztein S, Maxwell M H, de Lima J. Effect on aging on plasma renin and aldosterone in normal man.  Kidney International. 1975;  8 325-333
  • 87 Wu L T, Anthony J C. The estimated rate of depressed mood in US adults: recent evidence for a peak in later life.  J.Affect.Disord.. 2000;  60 159-171
  • 88 Zhu Z, Tepel M, Spieker C, Zidek W. Effect of extracellular Mg2+concentration on agonist-induced cytosolic free Ca2+ transients.  Biochim.Biophys.Acta. 1995;  1265 89-92

Katja Held, M.D. 

Max Planck Institute of Psychiatry

Kraepelinstrasse 10

80804 Munich

Germany

Phone: ++49 89 30622 400

Fax: ++49 89 30622 548

Email: held@mpipsykl.mpg.de

    >