Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Clin Sleep Med. 2021 Apr 1;17(4):739-748. doi: 10.5664/jcsm.9032.
The association between schizophrenia and narcolepsy has been controversial. We conducted a prospective case control study of schizophrenia and comorbid narcolepsy type 1 in adolescents compared with patients with either diagnosis alone and healthy controls using F-fluorodeoxy glucose positron emission tomography, sleep studies, and neurocognitive tests.
We included 11 patients (9-20 years old) with schizophrenia and comorbid narcolepsy type 1, 11 with narcolepsy type 1, 11 with schizophrenia, and 11 controls. All groups were matched for age and sex. Participants were required to submit to clinical interviews for sleep and psychiatric disorders, sleep questionnaires, continuous performance test, Wisconsin card sorting test, sleep studies including polysomnography, multiple sleep latency test and actigraphy, and positron emission tomography studies. All data were analyzed to compare the differences between the 4 groups.
The positron emission tomography results demonstrated significant differences in the dual diagnoses group compared with the 3 other groups. Compared with the controls, the dual diagnoses group had a significant presence of hypometabolism in the right mid-frontal, right orbital inferior frontal, and right posterior cingulum and a significant presence of hypermetabolism in the left amygdala, bilateral striatum, bilateral substantia nigra, bilateral basal ganglia, and bilateral thalamus. Continuous performance tests and Wisconsin card sorting tests showed that the dual diagnoses group had the worst performance.
Patients with schizophrenia and comorbid narcolepsy type 1 had different positron emission tomography findings than those with either schizophrenia or narcolepsy type 1 alone. They also had more neurocognitive impairments and required additional interventions.
精神分裂症和发作性睡病之间的关联一直存在争议。我们对青少年精神分裂症合并发作性睡病 1 型与单纯精神分裂症或发作性睡病患者进行了前瞻性病例对照研究，采用 F-氟脱氧葡萄糖正电子发射断层扫描、睡眠研究和神经认知测试。
我们纳入了 11 例精神分裂症合并发作性睡病 1 型患者（9-20 岁）、11 例发作性睡病 1 型患者、11 例精神分裂症患者和 11 例对照组。所有组均按年龄和性别匹配。所有参与者均需进行睡眠和精神障碍的临床访谈、睡眠问卷、连续性能测试、威斯康星卡片分类测试、包括多导睡眠图、多次睡眠潜伏期测试和活动记录仪的睡眠研究以及正电子发射断层扫描研究。分析所有数据以比较 4 组间的差异。
正电子发射断层扫描结果显示，双诊断组与其他 3 组相比存在显著差异。与对照组相比，双诊断组右侧额中回、右侧眶额下回和右侧后扣带回代谢明显降低，左侧杏仁核、双侧纹状体、双侧黑质、双侧基底节和双侧丘脑代谢明显升高。连续性能测试和威斯康星卡片分类测试显示，双诊断组的表现最差。
患有精神分裂症合并发作性睡病 1 型的患者与患有单纯精神分裂症或发作性睡病 1 型的患者相比，正电子发射断层扫描结果存在差异。他们还存在更多的神经认知障碍，需要额外的干预。
