Clinical and neurobiological aspects of narcolepsy

Nishino, Seiji

doi:10.1016/j.sleep.2007.03.008

Cited by 160 publications

(98 citation statements)

References 176 publications

(242 reference statements)

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“…The hcrt system has an important wake-promoting function and is involved in the control of motor activity. A defect in the hcrt-2 receptor, as well as destruction of hcrt-containing neurons in the hypothalamus, have been determined as causative factors in the canine and human forms of the sleep disorder, narcolepsy [26]. Interestingly, survey investigations have reported that BMI may be elevated in narcoleptic patients [27], and animal studies indicate that feeding and energy expenditure problems in hcrt deficient mice are directly related to the disruption in sleep-wake patterns [28].…”

Section: Effects Of Altered Metabolism On Sleep-wake Patternsmentioning

confidence: 99%

Sleep and circadian rhythms: Key components in the regulation of energy metabolism

et al. 2007

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In this review, we present evidence from human and animal studies to evaluate the hypothesis that sleep and circadian rhythms have direct impacts on energy metabolism, and represent important mechanisms underlying the major health epidemics of obesity and diabetes. The first part of this review will focus on studies that support the idea that sleep loss and obesity are ''interacting epidemics.'' The second part will discuss recent evidence that the circadian clock system plays a fundamental role in energy metabolism at both the behavioral and molecular levels. These lines of research must be seen as in their infancy, but nevertheless, have provided a conceptual and experimental framework that potentially has great importance for understanding metabolic health and disease. OverviewA major aspect of virtually all behavioral and physiological processes is daily variation mediated by the circadian timing system. Diurnal rhythms are generated by an internal biological clock that is synchronized to the 24-h day by environmental cues, primarily the light:dark cycle. When external timing signals are absent, the 24-h rhythms ''free run'' with a period close to 24 h, and are called ''circadian'' (about a day) rhythms. Many rhythms are overt and easy to recognize, such as the sleep-wake cycle, locomotor activity, and feeding behavior. The sleep-wake cycle is arguably the master output rhythm of the circadian clock, because the regulation of most behaviors and physiological activities depend on whether the organism is asleep or awake. A wide-range of less-easily observed rhythms occurs internally and includes the daily regulation of body temperature, adrenal corticosterone and pituitary hormone release, neuropeptide and neurotransmitter levels, sympathetic activation, energy metabolism (e.g., lipolysis, gluconeogenesis, insulin sensitivity, basal metabolic rate), as well as gene transcription. The evolution of a circadian system suggests that the ability of an organism to coordinate itself with the environment (external synchronization) and to maintain temporal organization of endogenous processes (internal synchronization) confers optimal health and survival potential. As we begin to unravel the many links between sleep, circadian rhythms, and metabolism, the survival benefits of temporal organization are beginning to emerge.The first mammalian circadian clock gene was discovered in 1997 by researchers at Northwestern University, and was given the name Clock (Circadian locomotor output cycles kaput), to represent the altered circadian phenotype in the Clock mutant mouse [1,2]. Since that time, there have been major advances in understanding the molecular basis of the circadian clock, including the discovery of many other circadian clock genes and the ongoing elucidation of transcriptional-translational feedback loops through which these clock genes interact [3]. Two important studies in the Clock mutant mouse provided evidence that circadian clock genes may be involved in more than just keeping time. First, it wa...

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Section: Effects Of Altered Metabolism On Sleep-wake Patternsmentioning

confidence: 99%

Sleep and circadian rhythms: Key components in the regulation of energy metabolism

et al. 2007

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“…2a) at all three sessions. This question could be addressed in terms of dysfunction of the hypocretin system in NC patients (for review, see Nishino, 2007) and tested by establishing (i) whether the low level of initial learning depends mainly on deficits in executive functions caused by the allocation of cognitive resources to monitor and maintain vigilance. Some support for this hypothesis (recently suggested by Naumann et al, 2006) could be found in the slight, but significantly lower accuracy in letter recognition of NC patients relative to controls (see Fig.…”

Section: Discussionmentioning

confidence: 99%

Sleep and time course of consolidation of visual discrimination skills in patients with narcolepsy–cataplexy

Cipolli

Campana

Campi

et al. 2009

Journal of Sleep Research

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SUMMAR Y The level of procedural skills improves in normal individuals when the acquisition is followed by a period of sleep rather than wake. If sleep plays an important role in the consolidation process the advantage it provides should be reduced or delayed when its organization is altered, as in patients with chronic sleep disorders. To test this prediction in patients with narcolepsy-cataplexy (NC), who usually have a more fragmented organization of sleep than normals, we compared the initial, intermediate and delayed level of consolidation of visual skills. Twenty-two drug-naive NC patients and 22 individually-matched controls underwent training at a texture discrimination task (TDT) and were re-tested on the next morning (after a night spent in laboratory with polysomnography) and after another six nights (spent at home). TDT performance was worse in patients than controls at training and at both retrieval sessions and the time course of consolidation was different in NC patients (who improved mainly from next-day to 7th-day retrieval session) compared with controls. Moreover, the lessimproving patients at next-day retrieval had a wider disorganization of sleep, probably because of an episode of rapid eye movement (REM) sleep at sleep onset REM, on post-training night more frequently than more-improving patients. These findings suggest that the time course of the consolidation process of procedural skills may be widely influenced by the characteristics of sleep organization (varying night-by-night much more in NC patients than controls) during post-training night.

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“…Dear Editor, Narcolepsy is a sleep disorder that causes functional impairment and it is underdiagnosed since it is rare (1). Main symptoms of narcolepsy include daytime excessive sleepiness and sleep attacks, cataplexia due to sudden loss of muscle tone in response to planned or unexpected situations, sleep paralysis, hypnogogic and hypnopompic hallucinations (2).…”

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confidence: 99%

“…Main symptoms of narcolepsy include daytime excessive sleepiness and sleep attacks, cataplexia due to sudden loss of muscle tone in response to planned or unexpected situations, sleep paralysis, hypnogogic and hypnopompic hallucinations (2). The term "narcolepsy" was used for the first time in 1880 by a French physician, Gélinea, to describe excessive sleepiness during daytime, sleep attacks and muscle weakness triggered by emotions in a patient (1).…”

mentioning

confidence: 99%