Hypocretin-1/orexin-A, sleep and excessive daytime sleepiness in patients with nonconvulsive status epilepticus: A cross-sectional cohort study.
Autor: | Slonkova J; University Hospital Ostrava, Department of Neurology, Ostrava, Poruba, Czech Republic; University of Ostrava Faculty of Medicine, Department of Clinical Neurosciences, Ostrava, Czech Republic. Electronic address: jana.slonkova@fno.cz., Togtokhjargal A; University Hospital Ostrava, Department of Neurology, Ostrava, Poruba, Czech Republic., Revendova KZ; University Hospital Ostrava, Department of Neurology, Ostrava, Poruba, Czech Republic; University of Ostrava Faculty of Medicine, Department of Clinical Neurosciences, Ostrava, Czech Republic., Bartos V; University Hospital Ostrava, Institute of Laboratory Medicine, Ostrava, Poruba, Czech Republic; University of Ostrava Faculty of Medicine, Department of Biomedical Sciences, Ostrava, Czech Republic., Hanzlikova P; University Hospital Ostrava, Institute of Radiodiagnostics, Ostrava, Poruba, Czech Republic; University of Ostrava Faculty of Medicine, Department of Imaging Methods, Ostrava, Czech Republic., Volny O; University Hospital Ostrava, Department of Neurology, Ostrava, Poruba, Czech Republic; University of Ostrava Faculty of Medicine, Department of Clinical Neurosciences, Ostrava, Czech Republic. |
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Jazyk: | angličtina |
Zdroj: | Sleep medicine [Sleep Med] 2024 Jul; Vol. 119, pp. 192-200. Date of Electronic Publication: 2024 Apr 20. |
DOI: | 10.1016/j.sleep.2024.04.019 |
Abstrakt: | Background and Objectives: Nonconvulsive status epilepticus (NCSE) manifests as a change in mental status without a coma (NCSE proper) or comatose NCSE. Hypocretin-1/orexin-A (H/O) is involved in alertness and sleep maintenance. Sleep impairment and excessive daytime sleepiness (EDS) have a negative impact on cognitive functions and activities of daily living (ADL). Methods: Patients meeting the NCSE criteria underwent cerebrospinal fluid and brain magnetic resonance imaging examinations, polysomnographies (PSG), multiple latency sleep tests (MSLT), and completed Epworth Sleepiness Scale (ESS). Montreal Cognitive Assessment was used to evaluate cognitive functions, and the Barthel Index was used to assess ADL in the acute phase (V1) and three months follow-up (V2). Results: From May 2020 to May 2023, we enrolled 15 patients, eight (53.3 %) women, with a median age of 69 (14) years. The median H/O CSF concentration was 250 (63.6) pg/ml; however, only three CSF samples (20 %) decreased below the borderline concentration of 200 pg/ml. Fourteen out of 15 patients (93.3 %) completed the PSG study. The median of wakefulness after sleep onset was 167 (173.5) min, sleep efficiency (SE) was 62.9 (63) %, sleep latency (SL) was 6 (32) min, REM sleep was 2.85 (7.2) %, and REM first episode latency was 210.5 (196.5) minutes. The medians of the stages N1 NREM were 4.65 (15) %, N2 NREM 68.4 (29.9) %, and N3 NREM 21.8 (35.5) %. MSLT mean latency was 7.7 (12.6) minutes. A significant negative correlation exists between H/O CSF concentrations and the stage N1 NREM (r Conclusions: Patients after NCSE exhibited sleep impairment and excessive daytime sleepiness. Hypocretin-1/orexin-A concentrations decreased only in 20 % of these cases. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Elsevier B.V. All rights reserved.) |
Databáze: | MEDLINE |
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