Neuropsychological Alterations in Narcolepsy with Cataplexy and the Expression of Cognitive Deficits

Abstract

Objectives:The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery.Methods:We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity.Results:Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared.Conclusions:Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients.

Cognitive dysfunction in central disorders of hypersomnolence: A systematic review

“…Park and Moraes showed that NT1 patients need more time than controls to complete both parts of the TMT [32,34]. The latter also reported a greater time cost of attentional shift in NT1 compared to controls, while this difference was not observed in the study of Medrano-Martinez [29]. Delazer and Zamarian administered the intra/extra dimensional set-shift test and did not find differences between NT1 and controls in the number of completed stages, trials needed to complete a stage, errors and errors adjusted for number of stages [17,18].…”

“…Park and Yoon administered the Stroop and reported no differences between NT1 and controls in terms of correct responses and RTs to correct responses [30,34]. Similarly, Kim and Medrano-Martinez did not find any differences between NT1 and controls at the Stroop word and colour test [29,31]. Moraes administered the Victoria Stroop without showing differences in accuracy between NT1 and controls but patients displayed slower RTs than controls [32].…”

“…Medrano-Martinez assessed digit and arithmetic spans. NT1 displayed a performance comparable to that of controls on digit reproduction but reported fewer items on the arithmetic test [29]. Total sample assessed: 243 NT1 compared to 15 IH and 266 healthy controls.…”

“…No differences emerged for the orienting and executive control network. Medrano-Martinez administered three attentional tasks with increasing difficulty [29]. NT1 displayed slower RTs but intact quality of performance on the simple RTs task, while on the multiple and complex RTs tasks, NT1 displayed slower RTs and made errors than controls.…”

Transtornos de humor em pacientes com alterações neuropsicológicas: uma revisão integrativa da literatura

“…Os transtornos de humor têm por principal característica a alteração no humor ou no afeto, comportamento, jeito de sentir e pensar, ou seja, afetam as funções cognitivas, prejudicando a atenção, a velocidade de processamento de informação, a fluência verbal e a resistência na interferência à estímulos. São considerados agravos à saúde mental nos quais as alterações de humor e afeto e podem se prolongar entre períodos de depressão e exaltação excessiva ou de euforia, ou ambos (American Psychiatric Association, 2014;Medrano-Martinez et al, 2018). As causas e os efeitos dos transtornos de humor devem ser entendidos, levando em consideração as dimensões biológicas, psicológicas e sociais dos indivíduos.…”