Functional Brain Activity Alterations in Type 1 Narcolepsy Patients with Anxiety and Depression: A 7-Tesla Resting State-Functional Magnetic Resonance Imaging Study.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-06-13 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S518104

Yang Chen, Jingyi Ye, Jiafei Chen, Zhiming Zhen, Chenglin Tang, Shuancheng Ren, Qi Han, Dong Gao

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Abstract

Purpose: This study aimed to investigate abnormal changes in brain region functional activity in type 1 narcolepsy (NT1) patients comorbid with anxiety and depression.

Methods: Twenty NT1 patients and 20 healthy controls (HCs) underwent subjective/objective sleep assessments (polysomnography, SAS, SDS) and 7T rs-fMRI to analyze regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuations (fALFF).

Results: Compared with the HCs group, NT1 patients had higher SAS and SDS scores. Analysis of the correlation between sleep parameters and brain activity in NT1 patients showed that increased ReHo values in the right insula and right cerebellum were negatively correlated with the TST (r = -0.463, p = 0.040) and excessive day time sleepiness (r = -0.486, p = 0.041). The fALFF of the left lingual gyrus positively correlated with sleep efficiency (r = 0.582, p = 0.007). Additionally, altered brain activity in NT1 patients was associated with emotional disorders. ReHo and fALFF values of the right insula showed a positive correlation with SAS scores (ReHo: r = 0.583, p = 0.011; fALFF: r = 0.557, p = 0.016), and the fALFF value of the left postcentral region also correlated positively with SAS scores (r = 0.597, p = 0.009). Moreover, the ReHo values of the left and postcentral lingua were positively correlated with the SDS scores (left lingua: r = 0.478, p = 0.045; postcentral lingua: r = 0.499, p = 0.035). The fALFF values of the left occipital inferior and postcentral regions also exhibited positive correlations with the SDS scores (left occipital inferior: r = 0.541, p = 0.020; postcentral regions: r = 0.550, p = 0.018).

Conclusion: Abnormalities of rs-fMRI activities in NT1 patients, particularly those in the insula, calcarine, lingual gyrus, and postcentral regions, were closely associated with sleep disturbance and emotional disorders. These findings provide a better understanding the pathophysiology of NT1 with emotional disorders. Future longitudinal studies with independent cohorts are needed to explore the underlying neural mechanisms for neuropsychiatric comorbidities in NT1.

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伴焦虑和抑郁的1型发作性睡患者的功能性脑活动改变：7特斯拉静息状态-功能磁共振成像研究

目的：本研究旨在探讨伴有焦虑和抑郁的1型发作性睡病（NT1）患者脑区功能活动的异常变化。方法：对20例NT1患者和20例健康对照（hc）进行主观/客观睡眠评估（多导睡眠图、SAS、SDS）和7T rs-fMRI分析区域均匀性（ReHo）和低频波动分数幅值（fALFF）。结果：与hc组相比，NT1患者的SAS和SDS评分较高。对NT1患者睡眠参数与脑活动的相关性分析显示，右脑岛和右小脑ReHo值升高与TST （r = -0.463, p = 0.040）和白天过度嗜睡（r = -0.486, p = 0.041）呈负相关。左舌回fALFF与睡眠效率呈正相关（r = 0.582, p = 0.007）。此外，NT1患者的大脑活动改变与情绪障碍有关。右脑岛ReHo、fALFF值与SAS评分呈正相关(ReHo: r = 0.583, p = 0.011；fALFF值：r = 0.557, p = 0.016)，左中央后区fALFF值也与SAS评分呈正相关（r = 0.597, p = 0.009）。左、后中央语言的ReHo值与SDS评分呈正相关(左语言：r = 0.478, p = 0.045；后中心语言：r = 0.499, p = 0.035)。左侧枕下和后中央区域的fALFF值也与SDS评分呈正相关(左枕下：r = 0.541, p = 0.020；后中心区域：r = 0.550, p = 0.018)。结论：NT1患者的rs-fMRI活动异常与睡眠障碍和情绪障碍密切相关，尤其是脑岛、脑钙、舌回和后中枢区域的异常。这些发现为更好地理解NT1伴情绪障碍的病理生理提供了依据。未来需要独立队列的纵向研究来探索NT1中神经精神合并症的潜在神经机制。

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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.