Effect of age on MSLT results in patients with narcolepsy-cataplexy
Effect of age on MSLT results in patients with narcolepsy-cataplexy
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DOI：
10.1212/01.wnl.0000101725.34089.1e
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发表时间：
2004-01-13
期刊：
影响因子：
9.9
通讯作者：
Montplaisir, J
中科院分区：
文献类型：
--
作者：
Dauvilliers, Y;Gosselin, A;Montplaisir, J
目的：在两个具有相似遗传背景的发作性睡病患者群体中，测量年龄对多次睡眠潜伏期测试 (MSLT) 特征、睡眠潜伏期和入睡快速眼动期次数 (SOREMP) 的影响。方法：从来自蒙彼利埃（法国）的 236 名明确的发作性睡病-猝倒-人类白细胞抗原 DR2 阳性患者和来自蒙特利尔（加拿大）的 147 名类似患者中获得了有关病情严重程度的临床和测谎信息。结果：结果显示，SOREMP 的数量随着年龄的增长而逐渐减少，而 MSLT 的平均睡眠潜伏期作为年龄的函数逐渐增加。这一发现还与根据临床病史评估的猝倒严重程度有关，随着年龄的增长，猝倒发作的频率逐渐减少。这些结果可能反映了正常衰老过程中睡眠潜伏期的逐渐增加，并表明临床改善可能是由于负责 SOREMP 的神经机制发生变化，而这种机制可能会随着年龄的增长而减弱。结论：随着年龄的变化，SOREMP 数量逐渐减少，MSLT 平均睡眠潜伏期增加，表明当前用于诊断的标准对于老年患者可能过于严格。因此，在诊断发作性睡病患者时，应考虑年龄对 MSLT 结果的主要影响。
Objective: To measure the effect of age on Multiple Sleep Latency Test (MSLT) characteristics, sleep latency, and number of sleep-onset REM periods (SOREMP) in two large populations of narcoleptic patients with similar genetic backgrounds. Methods: Clinical and polygraphic information on the severity of the condition was obtained on 236 well-defined narcolepsy-cataplexy-human leukocyte antigen DR2-positive patients from Montpellier (France) and on 147 similar patients from Montreal (Canada). Results: The results show a progressive decrease in the number of SOREMP with age and a progressive increase in the mean sleep latency on the MSLT as a function of age. This finding is also related to the severity of cataplexy as assessed from the clinical history with a progressive decrease in the frequency of cataplexy attacks with age. These results may reflect the progressive increase in sleep latency seen in normal aging and suggest that clinical improvement might be due to changes in the neural mechanisms responsible for SOREMP, which may weaken with age. Conclusions: The progressive decrease in the number of SOREMP and increase in the mean sleep latency on the MSLT as a function of age suggest that the current criteria used for diagnosis may be too stringent in older patients. The major influence of age on MSLT results should therefore be taken into account when diagnosing a narcoleptic patient.