Brain imaging and cognition in young narcoleptic patients
Brain imaging and cognition in young narcoleptic patients
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DOI：
10.1016/j.sleep.2015.11.023
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发表时间：
2016-08-01
期刊：
影响因子：
4.8
通讯作者：
Guilleminault, Christian
中科院分区：
文献类型：
--
作者：
Huang, Yu-Shu;Liu, Feng-Yuan;Guilleminault, Christian
发作性睡病患者和对照组的脑功能成像和表现之间的关系是一个新的研究领域，我们研究了71名年轻的1型发作性睡病患者和20名性别和年龄匹配的对照个体，使用脑正电子发射断层扫描（PET）图像和神经认知测试。使用睡眠-觉醒评估问卷进行临床调查;使用体动记录仪、多导睡眠图、多次睡眠潜伏期试验（MPERT）和血液检查（人类白细胞抗原分型）进行睡眠-觉醒研究。在PET研究的同一天进行连续操作测试（CPT）和威斯康星州卡片分类测试（WCST）。PET数据采用统计参数映射（第8版）软件进行分析，脑成像与神经认知功能的相关性采用Pearson相关分析。发作性睡病组71例（平均年龄16.15岁，其中男性41例（57.7%）），对照组20例（平均年龄15.1岁，其中男性12例（60%））。发作性睡病组CPT和WCST评分均显著低于对照组（P < 0.05）。与对照组相比，发作性睡病患者在右侧额叶中叶和角回表现为低代谢（P < 0.05），在嗅叶、海马、海马旁、杏仁核、梭状核、左下顶叶、左上级颞叶、纹状体、基底节和丘脑、右侧下丘脑和脑桥表现为高代谢（P < 0.05）。发作性睡病患者脑代谢活动的变化与嗜睡量表和行为测试的结果呈正相关。年轻的1型发作性睡病患者面临持续的认知障碍。我们的成像认知测试方案可以用于调查这些患者的治疗试验的效果。(C)© 2016 Elsevier B. V.版权所有。
The relationship between functional brain images and performances in narcoleptic patients and controls is a new field of investigation.We studied 71 young, type 1 narcoleptic patients and 20 sex- and age-matched control individuals using brain positron emission tomography (PET) images and neurocognitive testing. Clinical investigation was carried out using sleep-wake evaluation questionnaires; a sleep-wake study was conducted with actigraphy, polysomnography, multiple sleep latency test (MSLT), and blood tests (with human leukocyte antigen typing). The continuous performance test (CPT) and Wisconsin card sorting test (WCST) were administered on the same day as the PET study. PET data were analyzed using Statistical Parametric Mapping (version 8) software.Correlation of brain imaging and neurocognitive function was performed by Pearson's correlation. Statistical analyses (Student's t-test) were conducted with SPSS version-18.Seventy-one narcoleptic patients (mean age: 16.15 years, 41 boys (57.7%)) and 20 controls (mean age: 15.1 years, 12 boys (60%)) were studied. Results from the CPT and WCST showed significantly worse scores in narcoleptic patients than in controls (P < 0.05). Compared to controls, narcoleptic patients presented with hypometabolism in the right mid-frontal lobe and angular gyrus (P < 0.05) and significant hyper-metabolism in the olfactory lobe, hippocampus, parahippocampus, amygdala, fusiform, left inferior parietal lobe, left superior temporal lobe, striatum, basal ganglia and thalamus, right hypothalamus, and pons (P < 0.05) in the PET study. Changes in brain metabolic activity in narcoleptic patients were positively correlated with results from the sleepiness scales and performance tests.Young, type 1 narcoleptic patients face a continuous cognitive handicap. Our imaging cognitive test protocol can be useful for investigating the effects of treatment trials in these patients. (C) 2016 Elsevier B.V. All rights reserved.