Functional Brain Activity Alterations in Type 1 Narcolepsy Patients with Anxiety and Depression: A 7-Tesla Resting...

Area of Science:

• Neuroscience
• Medical Imaging
• Sleep Medicine

Background:

• Type 1 narcolepsy (NT1) is a chronic neurological disorder affecting sleep-wake regulation.
• Comorbid anxiety and depression are common in NT1 patients, impacting their quality of life.
• Understanding the neural underpinnings of these comorbidities is crucial for effective treatment.

Purpose of the Study:

• To investigate abnormal functional brain activity in NT1 patients with comorbid anxiety and depression.
• To explore the relationship between brain activity, sleep parameters, and emotional symptoms in NT1.

Main Methods:

• Utilized 7 Tesla resting-state functional magnetic resonance imaging (rs-fMRI) on 20 NT1 patients and 20 healthy controls (HCs).
• Assessed sleep and emotional status using polysomnography, the Stark Anxiety Scale (SAS), and the Stark Depression Scale (SDS).
• Analyzed regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuations (fALFF) to quantify brain activity.

Main Results:

• NT1 patients exhibited higher SAS and SDS scores compared to HCs.
• Increased ReHo in the right insula and cerebellum correlated negatively with total sleep time and daytime sleepiness.
• Altered fALFF in the left lingual gyrus correlated positively with sleep efficiency.
• Brain activity in the insula, lingual gyrus, and postcentral regions showed significant correlations with anxiety and depression scores.

Conclusions:

• Functional brain abnormalities in NT1 patients, especially in the insula, calcarine, lingual, and postcentral regions, are associated with sleep and emotional disturbances.
• These findings enhance the understanding of NT1 pathophysiology in the presence of emotional comorbidities.
• Further longitudinal studies are recommended to elucidate the neural mechanisms of neuropsychiatric comorbidities in NT1.