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Autonomic symptoms, cardiovascular and sudomotor evaluation in de novo type 1 narcolepsy

Abstract

Purpose

To evaluate cardiovascular and sudomotor function during wakefulness and to assess autonomic symptoms in de novo patients with type 1 narcolepsy compared to healthy controls.

Methods

De novo patients with type 1 narcolepsy (NT1) and healthy controls underwent cardiovascular function tests including head-up tilt test, Valsalva maneuver, deep breathing, hand grip, and cold face, and sudomotor function was assessed through Sudoscan. Autonomic symptoms were investigated using the Scales for Outcomes in Parkinson’s Disease–Autonomic Dysfunction (SCOPA-AUT) questionnaire.

Results

Twelve de novo patients with NT1 and 14 healthy controls were included. In supine rest condition and at 3 min and 10 min head-up tilt test, the systolic blood pressure values were significantly higher in the NT1 group than in controls (p < 0.05). A lower Valsalva ratio (p < 0.01), significantly smaller inspiratory–expiratory difference in deep breathing (p < 0.05), and lower delta heart rate in the cold face test (p < 0.01) were also observed in the NT1 group. The mean hand electrochemical skin conductance values were significantly lower (p < 0.05) and the mean SCOPA-AUT total scores were significantly higher in patients with NT1 than in healthy subjects (p < 0.001), with greater involvement of cardiovascular and thermoregulatory items.

Conclusion

De novo patients with NT1 exhibit blunted parasympathetic activity during wakefulness, mild sudomotor dysfunction, and a large variety of autonomic symptoms.

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Correspondence to Francesca Izzi.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Rocchi, C., Placidi, F., Del Bianco, C. et al. Autonomic symptoms, cardiovascular and sudomotor evaluation in de novo type 1 narcolepsy. Clin Auton Res 30, 557–562 (2020). https://doi.org/10.1007/s10286-020-00718-w

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Keywords

  • Narcolepsy type 1 (NT1)
  • Autonomic nervous system (ANS)
  • Cardiovascular reflexes
  • Sudomotor function
  • Scales for Outcomes in Parkinson’s Disease–Autonomic Dysfunction questionnaire (SCOPA-AUT)