Deng Fang, Zhang Yanan, Zhang Ran, Tang Qi, Guo Zhenni, Lv Yudan, Wang Zan, Yang Yi
Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Department of Neurology, Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2021 Mar 11;12:634660. doi: 10.3389/fneur.2021.634660. eCollection 2021.
We aimed to investigate the dynamic cerebral autoregulation (dCA) in patients with central disorders of hypersomnolence during wakefulness. Thirty-six patients with central disorders of hypersomnolence were divided into three groups according to polysomnography and multiple sleep latency test results: the idiopathic hypersomnia group (IH), narcolepsy type 1 without rapid-eye-movement sleep behavior disorder group (NT1-RBD), and narcolepsy type 1 with rapid-eye-movement sleep behavior disorder group (NT1 + RBD), with 12 patients in each group. Twelve sex- and age-matched healthy controls were recruited. We assessed the Epworth sleepiness scale (ESS) and dCA of all subjects. dCA was assessed by analyzing the phase difference (PD) using transfer function analysis. The ESS and dCA were analyzed before and after standardized treatment in 24 patients with narcolepsy type 1. The overall PD of the IH, NT1-RBD, and NT1 + RBD groups were lower than that of the control group ( < 0.001). There were no significant differences between the overall PD of the NT1-RBD and NT1 + RBD group ( > 0.05). The ESS scores decreased and the overall PD increased after treatment in 24 patients with narcolepsy type 1 ( < 0.001). Multivariable analysis showed that mean sleep latency in multiple sleep latency test was independently associated with impaired overall PD ( < 0.05). The dCA is impaired in patients with central disorders of hypersomnolence. The impairment of dCA occurs irrespective of NT1-RBD/+RBD. The ESS score and dCA improved in patients with narcolepsy type 1 after medication treatment. The mean sleep latency in multiple sleep latency test was independently associated with impaired dCA. www.ClinicalTrials.gov, identifier: NCT02752139.
我们旨在研究觉醒期中枢性过度嗜睡障碍患者的动态脑自动调节（dCA）。根据多导睡眠图和多次睡眠潜伏期测试结果，将36例中枢性过度嗜睡障碍患者分为三组：特发性嗜睡症组（IH）、无快速眼动睡眠行为障碍的发作性睡病1型组（NT1-RBD）和有快速眼动睡眠行为障碍的发作性睡病1型组（NT1+RBD），每组12例。招募了12名年龄和性别匹配的健康对照者。我们评估了所有受试者的爱泼华嗜睡量表（ESS）和dCA。通过传递函数分析相位差（PD）来评估dCA。对24例发作性睡病1型患者在标准化治疗前后的ESS和dCA进行了分析。IH组、NT1-RBD组和NT1+RBD组的总体PD均低于对照组（<0.001）。NT1-RBD组和NT1+RBD组的总体PD之间无显著差异（>0.05）。24例发作性睡病1型患者治疗后ESS评分降低，总体PD增加（<0.001）。多变量分析显示，多次睡眠潜伏期测试中的平均睡眠潜伏期与总体PD受损独立相关（<0.05）。中枢性过度嗜睡障碍患者存在dCA受损。无论是否有NT1-RBD/+RBD，dCA均会受损。发作性睡病1型患者药物治疗后ESS评分和dCA有所改善。多次睡眠潜伏期测试中的平均睡眠潜伏期与dCA受损独立相关。ClinicalTrials.gov，标识符：NCT
