Cerebrospinal Fluid Orexin A Levels and Autonomic Function in Kleine-Levin Syndrome
| Autor: | Han Yan, Kingman P. Strohl, Chang Jun Lv, Fang Han, Yuan Chang, Pei An, Qing Hua Li, Xueli Zhang, Jing Li, Zhan Cheng Gao, Ya-nan Liu, J. Wang, X. Zhang, Yan Hu, Long Zhao, Song X. Dong |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Adolescent Blood Pressure Irritability Gastroenterology Kleine-Levin Syndrome Neurological Disorders 03 medical and health sciences Orexin-A Young Adult 0302 clinical medicine Cerebrospinal fluid Heart Rate Recurrence Physiology (medical) Internal medicine Heart rate medicine Humans Child Orexins business.industry Middle Aged medicine.disease Pathophysiology Orexin 030104 developmental biology Blood pressure Kleine–Levin syndrome Beijing Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Sleep. 39(4) |
| ISSN: | 1550-9109 |
| Popis: | STUDY OBJECTIVES Kleine-Levin syndrome (KLS) is a rare disorder of relapsing sleepiness. The hypothesis was that the syndrome is related to a change in the vigilance peptide orexin A. METHODS From 2002 to 2013, 57 patients with relapsing hypersomnolence were clinically assessed in a referral academic center in Beijing, China, and 44 (28 males and 16 females; mean age 18.3 ± 8.9 y (mean ± standard deviation, range 9-57 y) were determined to have clinical and behavioral criteria consistent with KLS. Cerebrospinal fluid orexin A levels and diurnal blood pressure were measured in relapse versus remission in a subgroup of patients. RESULTS Presenting symptoms included relapsing or remitting excessive sleepiness-associated parallel complaints of cognitive changes (82%), eating disorders (84%); depression (45%); irritability (36%); hypersexuality (18%); and compulsions (11%). Episodes were 8.2 ± 3.3 days in duration. In relapse, diurnal values for blood pressure and heart rate were lower (P < 0.001). In a subgroup (n = 34), cerebrospinal fluid orexin A levels were ∼31% lower in a relapse versus remission (215.7 ± 81.5 versus 319.2 ± 95.92 pg/ml, P < 0.001); in three patients a pattern of lower levels during subsequent relapses was documented. CONCLUSIONS There are lower orexin A levels in the symptomatic phase than in remission and a fall and rise in blood pressure and heart rate, suggesting a role for orexin dysregulation in KLS pathophysiology. |
| Databáze: | OpenAIRE |
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