Department of Psychology, University of Rome "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy.
Behav Brain Funct. 2018 Dec 26;14(1):19. doi: 10.1186/s12993-018-0151-x.
Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. This disease affects significantly the overall patient functioning, interfering with social, work, and affective life. Some symptoms of narcolepsy depend on emotional stimuli; for instance, cataplectic attacks can be triggered by emotional inputs such as laughing, joking, a pleasant surprise, and also anger. Neurophysiological and neurochemical findings suggest the involvement of emotional brain circuits in the physiopathology of cataplexy, which seems to depending on the dysfunctional interplay between the hypothalamus and the amygdala associated with an alteration of hypocretin levels. Furthermore, behavioral studies suggest an impairment of emotions processing in narcolepsy-cataplexy (NC), like a probable coping strategy to avoid or reduce the frequency of cataplexy attacks. Consistently, NC patients seem to use coping strategies even during their sleep, avoiding unpleasant mental sleep activity through lucid dreaming. Interestingly, NC patients, even during sleep, have a different emotional experience than healthy subjects, with more vivid, bizarre, and frightening dreams. Notwithstanding this evidence, the relationship between emotion and narcolepsy is poorly investigated. This review aims to provide a synthesis of behavioral, neurophysiological, and neurochemical evidence to discuss the complex relationship between NC and emotional experience and to direct future research.
发作性睡病是一种慢性睡眠障碍，其特征是白天过度嗜睡、猝倒、催眠幻觉和睡眠瘫痪。这种疾病严重影响患者的整体功能，干扰社交、工作和情感生活。发作性睡病的一些症状取决于情绪刺激；例如，猝倒发作可能由情绪输入触发，如大笑、开玩笑、惊喜和愤怒。神经生理学和神经化学发现表明，情绪大脑回路参与了猝倒的病理生理学，这似乎取决于下丘脑和杏仁核之间的功能障碍相互作用，与食欲肽水平的改变有关。此外，行为研究表明发作性睡病-猝倒（NC）患者的情绪处理受损，这可能是一种避免或减少猝倒发作频率的应对策略。一致地，NC 患者似乎在睡眠期间也使用应对策略，通过清醒梦避免不愉快的精神睡眠活动。有趣的是，即使在睡眠中，NC 患者的情绪体验也与健康受试者不同，他们的梦境更生动、更离奇、更可怕。尽管有这些证据，但情绪与发作性睡病之间的关系尚未得到充分研究。本综述旨在综合行为、神经生理学和神经化学证据，讨论 NC 与情绪体验之间的复杂关系，并为未来的研究提供指导。
