Lancien Marion, Inocente Clara Odilia, Dauvilliers Yves, Kugener Beatrice, Scholz Sabine, Raverot Veronique, Lin Jian-Sheng, Guyon Aurore, Gustin Marie-Paule, Franco Patricia
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France.
INSERM U1061 and Sleep Unit, Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.
Sleep Med. 2017 May;33:57-60. doi: 10.1016/j.sleep.2016.12.027. Epub 2017 Feb 8.
The temporal association between sudden infant death syndrome (SIDS) and sleep suggests that the arousability from sleep provides a protective mechanism for survival. Recently, the hypocretin system, which promotes wakefulness, has been implicated in SIDS, since it has been reported that SIDS victims have fewer hypocretin neurons than infants who have died from other causes. To understand the role of hypocretin in SIDS, it is essential to better understand how this system matures. The present study compared cerebrospinal fluid (CSF) hypocretin in children aged 2-6 months, which is the age of peak incidence for SIDS, to both younger and older children.
Hypocretin levels were measured in CSF samples from 101 children who underwent a clinically relevant lumbar puncture. Children were separated into five age groups: 0-2 months, 2-6 months, 1-5 years, 5-10 years, and 10-18 years.
Hypocretin levels were not significantly different between 1-5 years, 5-10 years, and 10-18 years. Therefore, these three groups were pooled into a single one (1-18 years) for further analysis. Between the 0-2 month, 2-6 month, and 1-18 year groups, a significant difference in CSF hypocretin levels existed (p = 0.001). Simple comparisons showed that CSF hypocretin levels in the 2-6 month age group were significantly lower than hypocretin levels in both the 0-2 month and 1-18 year group (p < 0.001 and p = 0.008, respectively), but not significantly between 0-2 month and 1-18 year children.
The CSF hypocretin levels were lower at the age of peak incidence for SIDS. This could underlie an increased vulnerability to SIDS at this specific age.
婴儿猝死综合征（SIDS）与睡眠之间的时间关联表明，从睡眠中唤醒的能力为生存提供了一种保护机制。最近，促进清醒的下丘脑分泌素系统与SIDS有关，因为有报道称，SIDS受害者的下丘脑分泌素神经元比死于其他原因的婴儿少。为了了解下丘脑分泌素在SIDS中的作用，必须更好地了解该系统是如何成熟的。本研究比较了2至6个月大儿童（SIDS发病率最高的年龄）与年龄更小和更大儿童的脑脊液（CSF）下丘脑分泌素水平。
对101名接受了临床相关腰椎穿刺的儿童的脑脊液样本进行下丘脑分泌素水平测量。儿童被分为五个年龄组：0至2个月、2至6个月、1至5岁、5至10岁和10至18岁。
1至5岁、5至10岁和10至18岁组之间的下丘脑分泌素水平无显著差异。因此，将这三组合并为一个组（1至18岁）进行进一步分析。在0至2个月、2至6个月和1至18岁组之间，脑脊液下丘脑分泌素水平存在显著差异（p = 0.001）。简单比较显示，2至6个月龄组的脑脊液下丘脑分泌素水平显著低于0至2个月组和1至18岁组（分别为p < 0.001和p = 0.008），但0至2个月龄儿童与1至18岁儿童之间无显著差异。
在SIDS发病率最高的年龄，脑脊液下丘脑分泌素水平较低。这可能是该特定年龄SIDS易感性增加的原因。
