Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg. ; Department of Internal Medicine, Brothers of Charity Hospital, Trier, Germany.
Department of Neurology, University Hospital of Cologne, Cologne, Germany.
J Clin Neurol. 2014 Oct;10(4):314-9. doi: 10.3988/jcn.2014.10.4.314. Epub 2014 Oct 6.
Excessive daytime sleepiness and sudden sleep attacks are the main features of narcolepsy, but rapid-eye-movement sleep behavior disorder (RBD), hyposmia, and depression can also occur. The latter symptoms are nonmotor features in idiopathic Parkinson's disease (IPD). In the present study, IPD-proven diagnostic tools were tested to determine whether they are also applicable in the assessment of narcolepsy.
This was a case-control study comparing 15 patients with narcolepsy (PN) and 15 control subjects (CS) using the Scales for Outcomes in Parkinson's Autonomic Test (SCOPA-AUT), Parkinson's Disease Nonmotor Symptoms (PDNMS), University of Pennsylvania Smell Test, Farnsworth-Munsell 100 Hue test, Beck Depression Inventory, and the RBD screening questionnaire.
Both the PN and CS exhibited mild hyposmia and no deficits in visual tests. Frequent dysautonomia in all domains except sexuality was found for the PN. The total SCOPA-AUT score was higher for the PN (18.47±10.08, mean±SD) than for the CS (4.40±3.09), as was the PDNMS score (10.53±4.78 and 1.80±2.31, respectively). RBD was present in 87% of the PN and 0% of the CS. The PN were more depressed than the CS. The differences between the PN and CS for all of these variables were statistically significant (all p<0.05).
The results of this study provide evidence for the presence of dysautonomia and confirm the comorbidities of depression and RBD in narcolepsy patients. The spectrum, which is comparable to the nonmotor complex in IPD, suggests wide-ranging, clinically detectable dysfunction beyond the narcoleptic core syndrome.
日间过度嗜睡和突发性睡眠发作是发作性睡病的主要特征，但也可能出现快速眼动睡眠行为障碍（RBD）、嗅觉减退和抑郁。这些后两种症状是非运动性特征，存在于特发性帕金森病（IPD）中。在本研究中，我们测试了已被证实用于诊断 IPD 的工具，以确定它们是否也适用于发作性睡病的评估。
这是一项病例对照研究，比较了 15 例发作性睡病（PN）患者和 15 例对照（CS），使用帕金森自主功能测试量表（SCOPA-AUT）、帕金森病非运动症状量表（PDNMS）、宾夕法尼亚嗅觉测试、Farnsworth-Munsell 100 色调测试、贝克抑郁量表和 RBD 筛查问卷。
PN 和 CS 均表现出轻度嗅觉减退，视觉测试无缺陷。PN 所有领域均存在除性功能外的频繁自主神经功能障碍。PN 的总 SCOPA-AUT 评分（18.47±10.08，平均值±标准差）高于 CS（4.40±3.09），PDNMS 评分（10.53±4.78 和 1.80±2.31）也是如此。87%的 PN 存在 RBD，而 CS 中没有。PN 比 CS 更抑郁。这些变量在 PN 和 CS 之间的差异均具有统计学意义（所有 p<0.05）。
本研究结果为自主神经功能障碍的存在提供了证据，并证实了发作性睡病患者伴发抑郁和 RBD。该谱与 IPD 的非运动性复合体相当，表明除了发作性睡病核心综合征外，还存在广泛的、临床上可检测到的功能障碍。
