Dysautonomia in Narcolepsy: Evidence by Questionnaire Assessment

Abstract

Background and PurposeExcessive daytime sleepiness and sudden sleep attacks are the main features of narcolepsy, but rapid-eye-movement sleep behavior disorder (RBD), hyposmia, and depression can also occur. The latter symptoms are nonmotor features in idiopathic Parkinson's disease (IPD). In the present study, IPD-proven diagnostic tools were tested to determine whether they are also applicable in the assessment of narcolepsy.MethodsThis was a case-control study comparing 15 patients with narcolepsy (PN) and 15 control subjects (CS) using the Scales for Outcomes in Parkinson's Autonomic Test (SCOPA-AUT), Parkinson's Disease Nonmotor Symptoms (PDNMS), University of Pennsylvania Smell Test, Farnsworth-Munsell 100 Hue test, Beck Depression Inventory, and the RBD screening questionnaire.ResultsBoth the PN and CS exhibited mild hyposmia and no deficits in visual tests. Frequent dysautonomia in all domains except sexuality was found for the PN. The total SCOPA-AUT score was higher for the PN (18.47±10.08, mean±SD) than for the CS (4.40±3.09), as was the PDNMS score (10.53±4.78 and 1.80±2.31, respectively). RBD was present in 87% of the PN and 0% of the CS. The PN were more depressed than the CS. The differences between the PN and CS for all of these variables were statistically significant (all p<0.05).ConclusionsThe results of this study provide evidence for the presence of dysautonomia and confirm the comorbidities of depression and RBD in narcolepsy patients. The spectrum, which is comparable to the nonmotor complex in IPD, suggests wide-ranging, clinically detectable dysfunction beyond the narcoleptic core syndrome.

Predictive markers for early conversion of iRBD to neurodegenerative synucleinopathy diseases

“…27 Moreover, patients with iRBD often present with impaired autonomic functions and higher SCOPA-AUT scores. 28 In this study, the severity of autonomic disturbances was evaluated by the SCOPA-AUT questionnaire (including the urinary, gastrointestinal, cardiovascular, and thermoregulation systems), and the results showed that patients with higher scores more frequently developed neurodegenerative synucleinopathy diseases. During further analysis of these 4 domains of SCOPA-AUT (sexual disorder being excluded because most information about it could not be collected as a result of Chinese cultures), we found that the converters had higher scores for urinary, gastrointestinal, and cardiovascular systems.…”

Narcolepsy: the impact of aging, hypocretin deficiency, and years of formal education in olfactory function and abdominal obesity

“…Neurodegenerative diseases with autonomic disorders can be implicated in hyposmia 37 . There is also an increase in REM sleep behavior disorder and dysautonomy in questionnaire evaluations 38 . Dysautonomy correlates with systemic changes, having an effect not only on the olfactory function but also in body composition and in the increased risk of cardiometabolic diseases.…”

Superficial Vein Thrombosis as the Initial Manifestation of Protein S Deficiency in an Adolescent with Narcolepsy

“…Narcolepsy is characterized by hypersomnia, cataplexy etc. 7 Although the disease was first described towards the end of the 19th century, the underlying pathomechanisms were described only within the last decade. 8 The exact mechanisms of autoimmunity are poorly understood, but an increase in the incidence of narcolepsy after H1N1 infection and vaccination supported the hypothesis of an immune-mediated pathogenesis of narcolepsy.…”