Psychiatric Comorbidity and Cognitive Profile in Children with Narcolepsy with or without Association to the H1N1 Influenza Vaccination

Szakács, Attila; Hallböök, Tove; Tideman, Pontus; Darín, Niklas; Wentz, Elisabet

doi:10.5665/sleep.4582

Cited by 65 publications

(72 citation statements)

References 40 publications

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“…Reasons for this remain somewhat unclear. A more sudden onset and severe symptoms in pNT1 than in sporadic narcolepsy type 1 (NT1) could be an explaining factor [5,6]. On the other hand, a comparison between Finnish children with pNT1 and Italian children with NT1 appears to show similar clinical pictures, although subjects with pNT1 often had increased nocturnal sleep disturbance [14].…”

Section: Introductionmentioning

confidence: 98%

“…The main symptoms of narcolepsy are excessive daytime sleepiness, disturbed nocturnal sleep, cataplexy, sleep paralyses, and hallucinations during sleep-wake transitions. Other common associated features are increased weight, precocious puberty, behavioral problems, and psychiatric comorbidity [4][5][6]. There is a great heterogeneity in symptoms as some subjects are severely affected and disabled, whereas others manage without medication.…”

Section: Introductionmentioning

confidence: 99%

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Clinical course of H1N1-vaccine-related narcolepsy

2016

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Objective: To follow and analyze the clinical course and quality of life of Pandemrix H1N1-vaccinerelated narcolepsy (pNT1). Methods: Twenty-six drug-naïve confirmed pNT1 subjects completed Epworth Sleepiness Scale (ESS), Ullanlinna Narcolepsy Scale (UNS), Swiss Narcolepsy Scale (SNS), Rimon's Brief Depression scale (RDS), and WHO-5 Well-being index questionnaires near the disease onset and in a follow-up a minimum of two years later. The number of cataplexies and body mass index (BMI) were recorded. The effects of hypocretin-1 levels and sleep recording results were analyzed. The findings at the follow-up visit were compared with 25 non-vaccine-related type 1 narcolepsy (NT1) subjects. Results: In pNT1, RDS score decreased significantly (mean 10.2, SD 4.7 vs mean 6.7, SD 4.5, p = 0.003). Median of BMI increased from 20.8 kg m −2 to 23.4 kg m −2 , p < 0.001. There were no significant differences in other sleep scores. However, deviation and range in questionnaire scores at the follow-up were wide. Subjects with very low or undetectable hypocretin-1 levels had worse scores in UNS (mean 26.4, SD 6.95 vs mean 19.1, SD 3.83, p = 0.006) and ESS (mean 17.9, SD = 4.29 vs mean 14.1, SD = 3.70, p = 0.047) than those with hypocretin-1 levels of 20-110 pg/mL. Most disabling symptoms were excessive daytime sleepiness and disturbed sleep. There were no significant differences between the scores in pNT1 and NT1. Conclusions: Clinical course of pNT1 is heterogeneous but the evolution of pNT1 seems similar to NT1. Lower hypocretin levels in pNT1 are associated with a more severe phenotype.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Clinical course of H1N1-vaccine-related narcolepsy

2016

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“…Thus, up to 7% of all patients with a diagnosis of schizophrenia may have a psychotic variant of narcolepsy [1]. Conversely, psychotic symptoms of comorbid schizophrenia may forerun or present along the course of narcolepsy type 1 (NT1) [6,7,8,9,10]. The failure to distinguish narcolepsy leads to the labeling of patients as refractory to standard treatments for schizophrenia and delays the consideration of specific intervention for narcolepsy.…”

Section: Introductionmentioning

confidence: 99%

Schizophrenia-Like Symptoms in Narcolepsy Type 1: Shared and Distinctive Clinical Characteristics

et al. 2015

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Background/Aims: The occurrence of psychotic symptoms in narcolepsy type 1 (NT1) has been reported as responsible for delayed diagnosis due to the misdiagnosis of schizophrenia. This study aimed to identify shared and distinctive clinical characteristics between NT1 and schizophrenia, with the focus on psychotic symptoms. Methods: A total of 28 NT1 and 21 schizophrenia patients were included. Hallucination characteristics and PANSS (Positive and Negative Syndrome Scale), HRSD (Hamilton Rating Scale for Depression), DES (Dissociative Experiences Scale), and STAI (State-Trait Anxiety Inventory) scores were collected. Symptom overlap was investigated by χ², Fisher's or t tests and multiple logistic regression models. Results: Hallucinations and illusions frequently occurred in both diseases. Unimodal hallucinations were more common in schizophrenia (p = 6.30e-07) and multimodal hallucinations in NT1, but no clear difference was identified in their sensory modality. Hypnagogic/hypnopompic hallucinations were typical of NT1 (p = 5.22e-07), and 25% of NT1 patients exhibited some degree of insight deficit. Hypnagogic/hypnopompic hallucinations, unimodal hallucinations and PANSS score were the most distinctive clinical characteristics. Clinical overlap was found in the dissociative and anxiety domains, while higher depressive scores were observed in schizophrenia. Conclusion: The overlap between NT1 and schizophrenia should be further investigated under a clinical and pathogenetic point of view to improve diagnostic and therapeutic approaches.

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“…The four (20%) studies that looked at the intellectual implications of a hypersomnolence disorder all used one of the Wechsler assessments to determine intellectual functioning, with verbal IQ (VIQ) and nonverbal IQ (NVIQ) also reported. Two of the four studies (Dorris et al, 2008;Posar et al, 2014) were case studies employing standardised assessments that yielded quantitative data that resulted in individual rather than group The two studies (Szakács, 2016;Szakács et al, 2015) which were conducted with larger groups of children and adolescents with narcolepsy also found that most subjects had a FSIQ in the average range, with a number having a FSIQ in the gifted range. These studies investigated groups of 38 and 37 participants respectively, allowing some generalisability of results.…”

Section: Intellectual Functioning and Hypersomnolencementioning

confidence: 99%

“…In all seven studies, the EF and hypersomnolence association was irregularly explored with inconsistent methodologies, multiple definitions of EF, and numerous choices of assessment instruments. These included subtests from the Wechsler scales (Hansen, 1997;Ito et al;Szakács, 2016;Szakács et al, 2015), Wakefulness Test (MWT). This was used to identify vigilance.…”

Section: Executive Functioning and Hypersomnolencementioning

confidence: 99%

The Learning Implications for Children and Adolescents with Hypersomnolence

Ludwig¹

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The quantity and quality of sleep can impact behaviour, memory, cognition, executive function, attention, mood, and overall quality of life. Sleep disorders in children and adolescents range from behavioural insomnias, sleep breathing disorders, and sleep-wake transition disorders, through to disorders of excessive somnolence. Excessive daytime vi Publications included in this thesis Ludwig, B., Smith, S.S., & Heussler, H. (2018). Associations between neuropsychological, neurobehavioral and emotional functioning and either narcolepsy or idiopathic hypersomnia in children and adolescents.

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Psychiatric Comorbidity and Cognitive Profile in Children with Narcolepsy with or without Association to the H1N1 Influenza Vaccination

Cited by 65 publications

References 40 publications

Clinical course of H1N1-vaccine-related narcolepsy

Clinical course of H1N1-vaccine-related narcolepsy

Schizophrenia-Like Symptoms in Narcolepsy Type 1: Shared and Distinctive Clinical Characteristics

The Learning Implications for Children and Adolescents with Hypersomnolence

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