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Altered Brain Microstate Dynamics in Adolescents with Narcolepsy
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
University of Gothenburg, Sweden.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
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2016 (English)In: Frontiers in Human Neuroscience, ISSN 1662-5161, E-ISSN 1662-5161, Vol. 10, no 369Article in journal (Refereed) Published
Abstract [en]

Narcolepsy is a chronic sleep disorder caused by a loss of hypocretin-1 producing neurons in the hypothalamus. Previous neuroimaging studies have investigated brain function in narcolepsy during rest using positron emission tomography (PET) and single photon emission computed tomography (SPECT). In addition to hypothalamic and thalamic dysfunction they showed aberrant prefrontal perfusion and glucose metabolism in narcolepsy. Given these findings in brain structure and metabolism in narcolepsy, we anticipated that changes in functional magnetic resonance imaging (fMRI) resting state network (RSN) dynamics might also be apparent in patients with narcolepsy. The objective of this study was to investigate and describe brain microstate activity in adolescents with narcolepsy and correlate these to RSNs using simultaneous fMRI and electroencephalography (EEG). Sixteen adolescents (ages 13-20) with a confirmed diagnosis of narcolepsy were recruited and compared to age-matched healthy controls. Simultaneous EEG and fMRI data were collected during 10 min of wakeful rest. EEG data were analyzed for microstates, which are discrete epochs of stable global brain states obtained from topographical EEG analysis. Functional fMRI data were analyzed for RSNs. Data showed that narcolepsy patients were less likely than controls to spend time in a microstate which we found to be related to the default mode network and may suggest a disruption of this network that is disease specific. We concluded that adolescents with narcolepsy have altered resting state brain dynamics.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA , 2016. Vol. 10, no 369
Keywords [en]
narcolepsy; default mode network; functional magnetic resonance imaging (fMRI); electroencephalography (EEG); microstates; resting state networks; orexin; sleep
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-131167DOI: 10.3389/fnhum.2016.00369ISI: 000380989900001PubMedID: 27536225OAI: oai:DiVA.org:liu-131167DiVA, id: diva2:972168
Note

Funding Agencies|Research Council of South East Sweden (FORSS); Knut and Alice Wallenberg foundation (KAW); strategic research area of systems neurobiology at Linkoping University; Country council of Ostergotland Sweden

Available from: 2016-09-20 Created: 2016-09-12 Last updated: 2019-01-04
In thesis
1. Brain Networks and Dynamics in Narcolepsy
Open this publication in new window or tab >>Brain Networks and Dynamics in Narcolepsy
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Narcolepsy is a chronic sleep disorder, characterised by excessive daytime sleepiness with frequent uncontrollable sleep attacks. In addition to sleeprelated problems, changes in cognition have also been observed in patients with narcolepsy and has been linked to the loss of Orexin-A in a number of studies. Results from previous functional and structural neuroimaging studies would suggest that the loss of Orexin-A has numerous downstream effects in terms of both resting state glucose metabolism and perfusion and reduction in cortical grey matter.

Specifically, studies investigating narcolepsy with positron emission tomography (PET) and single photon emission computed tomography (SPECT) have observed aberrant perfusion and glucose metabolism in the hypothalamus and thalamus, as well as in prefrontal cortex. A very recent PET study in a large cohort of adolescents with type 1 narcolepsy further observed that the hypoand hypermetabolism in many of these cortico-frontal and subcortical brain regions also exhibited significant correlations with performance on a number of neurocognitive tests. These findings parallel those found in structural neuroimaging studies, where a reduction of cortical grey matter in frontotemporal areas has been observed.

The Aim of this thesis was to investigate mechanisms and aetiology behind the symptoms in narcolepsy through the application of different neuroimaging techniques. I present in this thesis evidence supporting that the complaints about subjective memory deficits in narcolepsy are related to a misallocation of resources.

I further describe how this has its seat in defective default mode network activation, possibly involving alterations to GABA and Glutamate signaling. In addition to this, I present our findings of a structural deviation in an area of the brainstem previously not described in the aetiology of narcolepsy.

This finding may have implications for further understanding the aetiology of the disease and the specific neuronal populations involved.

In addition to this, I show evidence from adipose tissue measurements in specific compartments, confirming that weight gain in narcolepsy is characterized by centrally located weight gain and may be specifically related to OX changes, but maybe not brown adipose tissue volume.

The findings presented in this thesis provides new insights to the pathophysiology of narcolepsy beyond the well-known depletion of OX producing neurons in the hypothalamus.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 54
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1651
National Category
Neurosciences Radiology, Nuclear Medicine and Medical Imaging Neurology Physiology
Identifiers
urn:nbn:se:liu:diva-153629 (URN)10.3384/diss.diva-153629 (DOI)9789176851814 (ISBN)
Public defence
2019-01-25, Hugo Theorells sal, Campus US, Linköping, 09:15 (English)
Opponent
Supervisors
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-09-30Bibliographically approved

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