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Neuroimaging of Narcolepsy

  • Chapter
Narcolepsy

Abstract

Narcolepsy–cataplexy is a disabling sleep disorder marked by excessive daytime sleepiness and sudden, uncontrollable decreases in muscle tone (cataplexy). It is believed to be caused by the autoimmune destruction of hypocretin (orexin) neurons in the hypothalamus. Neuroimaging studies, both structural and functional, have investigated the neural correlates of narcolepsy using a variety of imaging modalities, namely, magnetic resonance imaging, magnetic resonance spectroscopy, positron emission tomography, single-photon emission computed tomography and functional magnetic resonance imaging. Hypothalamic damage is a common, though not ubiquitous, finding among anatomical and spectroscopic studies, in support of the hypocretinergic depletion theory of narcoleptic pathophysiology. Alterations to fronto-temporal cortices and the thalamus were also found in a number of anatomical studies, possibly relating to cognitive, mood and sleep disturbances. As for functional imaging, several blood flow and metabolic studies have revealed hypoactivation in the hypothalamus, thalamus and fronto-temporal cortices during resting wakefulness, in agreement with structural data, but functional data during sleep are lacking. Emotional reactivity was probed in several functional imaging paradigms, the results of which converge with anatomical findings of hypothalamic and amygdalar changes in supporting an altered emotional network response in narcolepsy, possibly underlying cataplectic episodes. Lastly, extensive research has examined neurotransmission in narcolepsy, mostly dopaminergic, but no consistent difference was found between narcoleptic patients and controls. Overall, neuroimaging findings in narcolepsy constitute a substantial contribution to our knowledge of the pathophysiology of the disease.

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Authors and Affiliations

  1. Department of Exercise Science, Concordia University, 7141 Sherbrooke Street West, Montreal, H4B 1R6, Canada

    Jordan N. O’Byrne BSc, Ali Salimi BSc & Thien Thanh Dang-Vu MD, PhD

  2. Center for Studies in Behavioural Neurobiology, Concordia University, Montreal, Canada

    Jordan N. O’Byrne BSc, Ali Salimi BSc & Thien Thanh Dang-Vu MD, PhD

  3. Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, Canada

    Jordan N. O’Byrne BSc, Ali Salimi BSc & Thien Thanh Dang-Vu MD, PhD

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  1. Jordan N. O’Byrne BSc
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  2. Ali Salimi BSc
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  3. Thien Thanh Dang-Vu MD, PhD
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Correspondence to Thien Thanh Dang-Vu MD, PhD .

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Editors and Affiliations

  1. Montefiore Medical Center Narcolepsy Institute, Bronx, New York, USA

    Meeta Goswami

  2. Montefiore Hospital Sleep-Wake Disorders Center, Bronx, New York, USA

    Michael J. Thorpy

  3. Somnogen Canada Inc, President and Chief Executive Officer, Toronto, Ontario, Canada

    S.R. Pandi-Perumal

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O’Byrne, J.N., Salimi, A., Dang-Vu, T.T. (2016). Neuroimaging of Narcolepsy. In: Goswami, M., Thorpy, M., Pandi-Perumal, S. (eds) Narcolepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-23739-8_13

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