Yu Jiaqin, Zhou Yuyan, Han Xiao, Li Zongshan, Chen Feiyan, Zhang Lisan
School of Medicine, Shaoxing University, Shaoxing, Zhejiang, 312000, People's Republic of China.
Bio-X Laboratory, School of Physics, Zhejiang University, Hangzhou, 310027, People's Republic of China.
Nat Sci Sleep. 2024 Dec 12;16:2021-2028. doi: 10.2147/NSS.S491893. eCollection 2024.
The psychomotor vigilance task (PVT) is one of the main methods to measure sustained vigilance/attention in sleep research. Vigilance is the main factor affecting daytime function in patients with narcolepsy type 1 (NT1). We aimed to quantify the negative effects of sleep-wake disorders on vigilance and investigate potential neural mechanisms.
We compared data from 42 patients and 31 healthy controls, including sociodemographics, nighttime sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Epworth Sleepiness Scale, ESS), cognitive abilities (Montreal Cognitive Assessment, MoCA), emotional control (Barratt Impulsiveness Scale-11, BIS-11), depressive symptoms (Patient Health Questionnaire-9, PHQ-9), and PVT performance. PVT outcomes analyzed included number of lapses, reaction time (RT), variability in RT, and the slowest and fastest 10% of RTs. All patients were diagnosed with NT1 based on The International Classification of Sleep Disorders-Third Edition.
Patients with NT1 had a significantly higher body mass index and longer duration of education than healthy controls. The patients also had a greater tendency for daytime sleepiness and poorer nighttime sleep quality, higher depression and impulsiveness scores, and more severe cognitive dysfunction. PVT performance was better in the healthy controls than in patients with NT1. We also noticed that emotional changes and the proportion of rapid eye movement sleep at night are related to PVT performance.
More severe sleepiness and an increased emotional burden could underlie the arousal and vigilance deficits seen in patients with NT1. We speculate that impaired vigilance in patients with NT1 is associated with abnormal brain function caused by a resource allocation imbalance related to hypothalamic orexin neuron damage, sleep inertia may also have a slight impact on this. Future studies should delve into this topic more deeply.
心理运动警觉任务（PVT）是睡眠研究中测量持续警觉/注意力的主要方法之一。警觉是影响1型发作性睡病（NT1）患者白天功能的主要因素。我们旨在量化睡眠-觉醒障碍对警觉的负面影响，并研究潜在的神经机制。
我们比较了42例患者和31名健康对照者的数据，包括社会人口统计学、夜间睡眠质量（匹兹堡睡眠质量指数，PSQI）、嗜睡程度（爱泼华嗜睡量表，ESS）、认知能力（蒙特利尔认知评估量表，MoCA）、情绪控制（巴拉特冲动性量表-11，BIS-11）、抑郁症状（患者健康问卷-9，PHQ-9）以及PVT表现。分析的PVT结果包括失误次数、反应时间（RT）、RT的变异性以及RT最快和最慢的10%。所有患者均根据《国际睡眠障碍分类第三版》被诊断为NT1。
NT1患者的体重指数显著高于健康对照者，受教育时间也更长。患者白天嗜睡的倾向更明显，夜间睡眠质量更差，抑郁和冲动得分更高，认知功能障碍更严重。健康对照者的PVT表现优于NT1患者。我们还注意到情绪变化和夜间快速眼动睡眠的比例与PVT表现有关。
更严重的嗜睡和情绪负担增加可能是NT1患者出现觉醒和警觉缺陷的原因。我们推测，NT1患者的警觉受损与下丘脑食欲素神经元损伤导致的资源分配失衡引起的脑功能异常有关，睡眠惯性可能也对此有轻微影响。未来的研究应更深入地探讨这一话题。
