Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France.
Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Sleep Res. 2024 Apr;33(2):e13925. doi: 10.1111/jsr.13925. Epub 2023 May 24.
REM sleep behaviour disorder (RBD) is common in narcolepsy type 1 (NT1). Abnormalities in the reward system have been observed in NT1, possibly related to impaired orexin projections towards the mesolimbic reward system, but also in RBD when associated with Parkinson's disease. Our study aimed to explore the psychobehavioural profile of NT1 patients with and without RBD compared with healthy controls (HC). Forty patients with NT1 were compared with 20 sex- and age-matched HC. All patients with NT1 underwent a video-polysomnography including a measure of REM sleep without atonia (RSWA). The following neuropsychobehavioural variables were assessed: apathy, impulsivity, depression, cognition, subjective and objective attention, sensation-seeking, and behavioural addictions. The patient population included 22 patients with NT1-RBD and 18 patients with NT1-noRBD. Compared with the healthy controls, patients with NT1 had higher scores of apathy, impulsivity, and depression; a lower score on global cognition, and poorer self-perceived attention. No differences were found between patients with NT1 with and without RBD in all neuropsychological variables, except for impaired objective attention in patients with NT1-RBD. In patients with NT1, a positive correlation was observed between RSWA and both apathy and impulsivity subscale. Moreover, in patients with NT1-RBD, RSWA was positively correlated with depression. Patients with NT1 showed higher depression, apathy, and impulsivity compared with controls. These measures correlate with the severity of RSWA, suggesting a transdiagnostic association between RBD and abnormalities of the reward system at least for patients with NT1.
快速眼动睡眠行为障碍（RBD）在 1 型发作性睡病（NT1）中较为常见。在 NT1 中观察到奖励系统异常，这可能与下丘脑泌素投射到中脑边缘奖励系统受损有关，但在与帕金森病相关的 RBD 中也存在这种情况。我们的研究旨在探讨伴有和不伴有 RBD 的 NT1 患者与健康对照组（HC）的心理行为特征。将 40 名 NT1 患者与 20 名性别和年龄匹配的 HC 进行比较。所有 NT1 患者均接受视频多导睡眠图检查，包括 REM 睡眠无张力（RSWA）测量。评估了以下神经心理行为变量：冷漠、冲动、抑郁、认知、主观和客观注意力、寻求刺激和行为成瘾。患者人群包括 22 名 NT1-RBD 患者和 18 名 NT1-noRBD 患者。与健康对照组相比，NT1 患者的冷漠、冲动和抑郁评分较高；整体认知评分较低，自我感知注意力较差。在所有神经心理学变量中，NT1 患者无论是否存在 RBD，均未发现差异，但 NT1-RBD 患者的客观注意力受损。在 NT1 患者中，RSWA 与冷漠和冲动亚量表呈正相关。此外，在 NT1-RBD 患者中，RSWA 与抑郁呈正相关。与对照组相比，NT1 患者表现出更高的抑郁、冷漠和冲动。这些措施与 RSWA 的严重程度相关，表明 RBD 与奖励系统异常之间存在跨诊断关联，至少对于 NT1 患者是如此。
