Brabec Jiri, Rulseh Aaron, Horinek Daniel, Pala Andrej, Guerreiro Helena, Buskova Jitka, Petrovicky Pavel, Nemcova Veronika, Krasensky Jan, Seidl Zdenek, Nimsky Christopher, Sonka Karel
Institute of Anatomy, Charles University, Prague, Czech Republic.
Neuro Endocrinol Lett. 2011;32(5):652-6.
Based on the clinical observation that patients suffering from narcolepsy with cataplexy (NC) have cataplectic attacks when they experience positive emotions, it is therefore hypothesised that the abnormal processing of external emotional input through the limbic system, or motor dysregulation induced by emotions, takes place during these episodes. To date, imaging studies have failed to reveal consistent brain abnormalities in NC patients.
Considering the discrepancies in reported structural or functional abnormalities of the hypothalamus, amygdala, and nucleus accumbens, we used the MRI volumetry to determine the volumes of the amygdala and nucleus accumbens in a group of eleven patients with NC (5 males and 6 females, mean age 41.7 years ± 17.7). This data was compared to an equal number of examinations in healthy volunteers matched for age and gender.
We found a decrease in the amygdalar volume of NC patients in both raw (p<0.001) and relative (p<0.01) data sets. The difference in amygdalar volume between healthy volunteers and NC patients was about 17%. In contrast to the amygdala, we did not find any differences in the volumes of nucleus accumbens.
In the present MRI volumetric study, we found bilateral gray matter loss in the amygdala only.
基于发作性睡病伴猝倒（NC）患者在经历积极情绪时会出现猝倒发作这一临床观察结果，因此推测在这些发作期间，通过边缘系统对外部情绪输入的异常处理或情绪诱导的运动失调会发生。迄今为止，影像学研究未能揭示NC患者一致的脑异常情况。
考虑到下丘脑、杏仁核和伏隔核在结构或功能异常报告方面的差异，我们使用MRI容积测定法来确定一组11名NC患者（5名男性和6名女性，平均年龄41.7岁±17.7岁）的杏仁核和伏隔核体积。将该数据与年龄和性别匹配的同等数量健康志愿者的检查结果进行比较。
我们发现，在原始（p<0.001）和相对（p<0.01）数据集中，NC患者的杏仁核体积均减小。健康志愿者与NC患者之间杏仁核体积的差异约为17%。与杏仁核不同，我们未发现伏隔核体积存在任何差异。
在本MRI容积测定研究中，我们仅发现杏仁核存在双侧灰质丢失。
