Impaired Vigilance in Patients with Narcolepsy Type 1: A Psychomotor Vigilance Task Study.

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2024-12-12 eCollection Date: 2024-01-01 DOI:10.2147/NSS.S491893

Jiaqin Yu, Yuyan Zhou, Xiao Han, Zongshan Li, Feiyan Chen, Lisan Zhang

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引用次数: 0

Abstract

Purpose: 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.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

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1型发作性睡病患者的警觉性受损：一项精神运动警觉性任务研究。

目的：精神运动警戒任务（PVT）是睡眠研究中测量持续警戒/注意的主要方法之一。警惕性是影响1型发作性睡患者白天功能的主要因素。我们的目的是量化睡眠-觉醒障碍对警觉性的负面影响，并研究潜在的神经机制。患者和方法：我们比较了42名患者和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（Epworth嗜睡量表，ESS）、认知能力（蒙特利尔认知评估，MoCA）、情绪控制（Barratt冲动量表-11，BIS-11）、抑郁症状（患者健康问卷-9，PHQ-9）和PVT表现。PVT结果分析包括发作次数、反应时间（RT）、RT变异性、最慢和最快的10%的RT。所有患者均根据《国际睡眠障碍分类-第三版》诊断为NT1。结果：NT1患者的身体质量指数明显高于健康对照组，受教育时间明显长于健康对照组。这些患者白天嗜睡的倾向更大，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。健康对照组的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。结论：更严重的嗜睡和增加的情绪负担可能是NT1患者觉醒和警觉性缺陷的基础。我们推测NT1患者的警觉性受损与下丘脑食欲素神经元损伤相关的资源分配失衡引起的脑功能异常有关，睡眠惯性也可能对此有轻微影响。未来的研究应该对这一课题进行更深入的探讨。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.