DTI-ALPS 指数和脉络丛体积的变化与 1 型嗜睡症患者的临床症状有关。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-10-15 DOI:10.1016/j.sleep.2024.10.019

Pengxin Hu , Yuqing Yuan , Yu Zou , Ruifang Xiong , Jiankun Dai , Xihai Zhao , Liang Xie , Xiaoping Tang

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引用次数: 0

摘要

背景：1 型嗜睡症（NT1）是一种睡眠障碍，其特征是白天过度嗜睡并伴有惊厥。睡眠障碍已被证明会影响甘油系统。本研究旨在评估 NT1 患者沿血管周围空间弥散张量成像（DTI-ALPS）指数和脉络丛（CP）体积的变化，并进一步探讨其临床意义：方法：我们在本医院前瞻性地招募了根据脑脊液视网膜下素-1浓度和多次睡眠潜伏期测试被诊断为NT1的患者。所有参与者均接受了核磁共振成像检查，以分析 DTI-ALPS 指数和 CP 容量。随后，我们对 DTI-ALPS 指数、CP 容量和重要临床参数（包括埃普沃思嗜睡量表 (ESS) 评分、Narcolepsy 严重程度量表 (NSS) 评分、快速眼动睡眠 (REM) 阶段比率、非快速眼动睡眠 (N1) 阶段比率、非快速眼动睡眠 (N2) 阶段比率和非快速眼动睡眠 (N3) 阶段比率）进行了相关性分析。以年龄、性别、体重指数和侧脑室容积为协变量，对 DTI-ALPS 指数和 CP 容积进行了组间分析和相关分析：本研究共纳入了 41 名 NT1 患者和 42 名健康对照组（HC）。NT1患者的DTI-ALPS指数明显低于HC（1.444 ± 0.119 vs.1.661 ± 0.135，P FDR校正后FDR校正后=0.010），但与阶段N3比值呈正相关（PFDR校正后=0.033）。NT1参与者的CP体积与ESS（PFDR校正后=0.047）和NSS评分（PFDR校正后=0.047）呈正相关，但与N3期比率（PFDR校正后=0.047）呈负相关：我们的研究表明，NT1参与者的DTI-ALPS指数较低，CP体积较大。NT1患者的DTI-ALPS指数和CP体积与疾病严重程度和睡眠结构有关。这些发现可为了解 NT1 的发病机制提供新的视角。

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Alterations in the DTI-ALPS index and choroid plexus volume are associated with clinical symptoms in participants with narcolepsy type 1

Background

Narcolepsy type 1 (NT1) is a sleep disorder characterized by excessive daytime sleepiness accompanied by cataplexy. Sleep disorders have been shown to affect the glymphatic system. This study aimed to evaluate changes in the diffusion tensor imaging along the perivascular space (DTI-ALPS) index and choroid plexus (CP) volume in NT1 participants, and to further explore their clinical significance.

Methods

We prospectively enrolled participants diagnosed with NT1 based on cerebrospinal fluid hypocretin-1 concentration and multiple sleep latency tests at our hospital. All participants underwent MRI to allow analysis of the DTI-ALPS index and CP volume. We subsequently performed correlation analyses between the DTI-ALPS index, CP volume, and important clinical parameters, including the Epworth Sleepiness Scale (ESS) score, Narcolepsy Severity Scale (NSS) score, stage rapid eye movement sleep (REM) ratio, stage 1 non-REM (N1) ratio, stage 2 non-REM (N2) ratio, and stage 3 non-REM (N3) ratio, among the NT1 participants. Inter-group and correlation analyses of DTI-ALPS index and CP volume were performed using age, sex, body mass index, and lateral ventricle volume as covariates.

Results

This study enrolled 41 NT1 participants and 42 healthy controls (HC). The DTI-ALPS index of NT1 participants was significantly lower than HC (1.444 ± 0.119 vs.1.661 ± 0.135, P < 0.001), while the CP volume of NT1 participants was significantly larger than those of HC (0.831 ± 0.146 vs. 0.645 ± 0.137, P < 0.001). The DTI-ALPS index was negatively correlated with both the ESS (P_{FDR-corrected}<0.001) and NSS scores (P_{FDR-corrected} = 0.010), but positively correlated with the Stage N3 ratio (P_{FDR-corrected} = 0.033). The CP volume of NT1 participants was positively correlated with ESS (P_{FDR-corrected} = 0.047) and NSS scores (P_{FDR-corrected} = 0.047), but negatively correlated with the stage N3 ratio (P_{FDR-corrected} = 0.047).

Conclusion

Our study suggests that the DTI-ALPS index was lower and CP volume was larger in NT1 participants. The DTI-ALPS index and CP volume in the NT1 participants were related to disease severity and sleep structure. These findings may provide new insights into the mechanisms underlying NT1.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.