A brain PET study in patients with narcolepsy-cataplexy

Autor: Jacques Touchon, Bertrand Carlander, Michel Zanca, Frédéric Comte, Sophie Bayard, Yves Dauvilliers
Přispěvatelé: Laboratoire des colloïdes, verres et nanomatériaux (LCVN), Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2009
Předmět:
Blood Glucose
Male
Cingulate cortex
Cataplexy
Neurological disorder
ACTIVATION
Lingual gyrus
0302 clinical medicine
Image Processing
Computer-Assisted
Brain Mapping
0303 health sciences
[SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences
Brain
Middle Aged
Magnetic Resonance Imaging
Psychiatry and Mental health
MODAFINIL
Anesthesia
[PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph]
Hypermetabolism
Female
medicine.symptom
Psychology
medicine.drug
Adult
[PHYS.PHYS.PHYS-BIO-PH]Physics [physics]/Physics [physics]/Biological Physics [physics.bio-ph]
Polysomnography
[PHYS.PHYS.PHYS-ED-PH]Physics [physics]/Physics [physics]/Physics Education [physics.ed-ph]
Young Adult
03 medical and health sciences
Imaging
Three-Dimensional
Fluorodeoxyglucose F18
medicine
Humans
[PHYS.PHYS.PHYS-INS-DET]Physics [physics]/Physics [physics]/Instrumentation and Detectors [physics.ins-det]
Wakefulness
Dominance
Cerebral
Narcolepsy
030304 developmental biology
Modafinil
ATTENTION
Limbic lobe
medicine.disease
Positron-Emission Tomography
ONSET
TASK
Surgery
Neurology (clinical)
HYPERSOMNIAS
SLEEP-DEPRIVATION
030217 neurology & neurosurgery
Zdroj: Journal of Neurology, Neurosurgery and Psychiatry
Journal of Neurology, Neurosurgery and Psychiatry, BMJ Publishing Group, 2010, 81, pp.344-348. ⟨10.1136/jnnp.2009.175786⟩
ISSN: 0022-3050
1468-330X
DOI: 10.1136/jnnp.2009.175786
Popis: International audience; Objective To investigate brain changes in both basal and cataplectic conditions in awake patients with narcolepsy-cataplexy.;Background Recent insights in pathophysiology have demonstrated that narcolepsy-cataplexy is caused by early loss of hypothalamus hypocretin neurons. However, the neurophysiological mechanisms underlying sleepiness and the dramatic cataplexy reaction to positive emotion remain unclear.;Methods Twenty-one patients with narcolepsy-cataplexy and 21 age- and sex-matched controls were included. Diagnosis of narcolepsy was fully confirmed by polysomnography, HLA DQB1*0602 and CSF hypocretin levels (n=9). Seven patients were free of all drugs, and 14 were treated with psychostimulant and/or anticataplectic drugs. (18)-F-fluorodeoxy glucose positron emission tomography procedures were performed at baseline in all subjects and during cataplexy attacks (n=2).;Results The authors found significant hypermetabolism in narcolepsy-cataplexy in fully awake condition in the limbic cortex specifically in the anterior and mid cingulate cortex, in the right cuneus and lingual gyrus. In contrast, no hypometabolism was found. Hypermetabolism was detected in the cerebellum and pre-postcentral gyri in treated compared with untreated patients. During cataplectic attacks, cerebral metabolism significantly increased in the bilateral pre-postcentral gyri, primary somatosensory cortex, with a marked decrease in the hypothalamus.;Conclusion Hypermetabolism was found in the executive network in narcolepsy at baseline in fully awake condition. Wake state assessment during scanning appears critical to avoid results showing altered functional neurocircuitry secondary to sleepiness and not to the underlying neurological disorder per se. Finally, cataplexy attacks were characterised by a hypometabolism in the hypothalamus associated with wide bilateral brain area hypermetabolisms.
Databáze: OpenAIRE
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