Center for Health Sciences, SRI International, Menlo Park, CA, USA; Department of General Psychology, University of Padua, Padua, Italy.
J Sleep Res. 2014 Aug;23(4):432-40. doi: 10.1111/jsr.12133. Epub 2014 Feb 21.
Narcolepsy with cataplexy is a complex sleep disorder that affects the modulation of emotions: cataplexy, the key symptom of narcolepsy, is indeed strongly linked with emotions that usually trigger the episodes. Our study aimed to investigate haemodynamic and behavioural responses during emotional stimulation in narco-cataplexy. Twelve adult drug-naive narcoleptic patients (five males; age: 33.3 ± 9.4 years) and 12 healthy controls (five males; age: 30.9 ± 9.5 years) were exposed to emotional stimuli (pleasant, unpleasant and neutral pictures). Heart rate, arterial blood pressure and mean cerebral blood flow velocity of the middle cerebral arteries were continuously recorded using photoplethysmography and Doppler ultrasound. Ratings of valence and arousal and coping strategies were scored by the Self-Assessment Manikin and by questionnaires, respectively. Narcoleptic patients' haemodynamic responses to pictures overlapped with the data obtained from controls: decrease of heart rate and increase of mean cerebral blood flow velocity regardless of pictures' content, increase of systolic blood pressure during the pleasant condition, and relative reduction of heart rate during pleasant and unpleasant conditions. However, when compared with controls, narcoleptic patients reported lower arousal scores during the pleasant and neutral stimulation, and lower valence scores during the pleasant condition, respectively, and also a lower score at the 'focus on and venting of emotions' dimensions of coping. Our results suggested that adult narcoleptic patients, compared with healthy controls, inhibited their emotion-expressive behaviour to emotional stimulation, and that may be related to the development of adaptive cognitive strategies to face emotions avoiding cataplexy.
发作性睡病伴猝倒症是一种复杂的睡眠障碍，会影响情绪的调节：猝倒症是发作性睡病的主要症状，与通常引发猝倒发作的情绪密切相关。我们的研究旨在探讨发作性睡病伴猝倒症患者在情绪刺激下的血液动力学和行为反应。12 名未经药物治疗的成年发作性睡病患者（男性 5 名；年龄：33.3 ± 9.4 岁）和 12 名健康对照者（男性 5 名；年龄：30.9 ± 9.5 岁）接受了情绪刺激（愉快、不愉快和中性图片）。使用光体积描记法和多普勒超声连续记录心率、动脉血压和大脑中动脉平均血流速度。通过自我评估情绪图和问卷分别对效价和唤醒评分以及应对策略进行评分。发作性睡病患者对图片的血液动力学反应与从对照组获得的数据重叠：无论图片内容如何，心率下降和大脑中动脉平均血流速度增加，在愉快条件下收缩压增加，在愉快和不愉快条件下心率相对降低。然而，与对照组相比，发作性睡病患者在愉快和中性刺激时报告的唤醒评分较低，在愉快条件时报告的效价评分较低，在应对的“关注和宣泄情绪”维度上的评分也较低。我们的结果表明，与健康对照组相比，成年发作性睡病患者抑制了对情绪刺激的情绪表达行为，这可能与为避免猝倒发作而发展的适应性认知策略有关。
