Executive attention and working memory in narcoleptic outpatients

Moraes, Mirleny; Rossini, Sueli; Reimão, Rubens

doi:10.1590/s0004-282x2012005000007

Cited by 17 publications

(18 citation statements)

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“…A consensus is that medial dorsal nuclei of the thalamus, prefrontal cortex and ventral striatum form an interconnected neural circuit that subserves the certain working memory functions (Block et al ., ; Floresco et al ., ). In line with previous literatures (Moraes et al ., ; Naumann et al ., ), patients showed lower scores in tests of working memory. Furthermore, a former functional MRI study revealed that the ventrolateral prefrontal cortex was a key structure underlying episodic memory, with the left side involved in verbal information processing and the right side involved in visual information processing (Dickerson and Eichenbaum, ).…”

Section: Discussionmentioning

confidence: 99%

White matter alterations in narcolepsy patients with cataplexy: tract‐based spatial statistics

Park

Kwon

Joo

et al. 2015

Journal of Sleep Research

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SUMMARYFunctional imaging studies and voxel-based morphometry analysis of brain magnetic resonance imaging showed abnormalities in the hypothalamus-thalamus-orbitofrontal pathway, demonstrating altered hypocretin pathway in narcolepsy. Those distinct morphometric changes account for problems in wake-sleep control, attention and memory. It also raised the necessity to evaluate white matter changes. To investigate brain white matter alterations in drug-na€ ıve narcolepsy patients with cataplexy and to explore relationships between white matter changes and patient clinical characteristics, drug-na€ ıve narcolepsy patients with cataplexy (n = 22) and healthy age-and gender-matched controls (n = 26) were studied. Fractional anisotropy and mean diffusivity images were obtained from whole-brain diffusion tensor imaging, and tract-based spatial statistics were used to localize white matter abnormalities. Compared with controls, patients showed significant decreases in fractional anisotropy of white matter of the bilateral anterior cingulate, fronto-orbital area, frontal lobe, anterior limb of the internal capsule and corpus callosum, as well as the left anterior and medial thalamus. Patients and controls showed no differences in mean diffusivity. Among patients, mean diffusivity values of white matter in the bilateral superior frontal gyri, bilateral fronto-orbital gyri and right superior parietal gyrus were positively correlated with depressive mood. This tract-based spatial statistics study demonstrated that drug-na€ ıve patients with narcolepsy had reduced fractional anisotropy of white matter in multiple brain areas and significant relationship between increased mean diffusivity of white matter in frontal/cingulate and depression. It suggests the widespread disruption of white matter integrity and prevalent brain degeneration of frontal lobes according to a depressive symptom in narcolepsy. IN TROD UCTI ONNarcolepsy is a disabling sleep disorder characterized by excessive daytime sleepiness (EDS) and manifestations of abnormal rapid eye movement (REM) sleep, including cataplexy, sleep paralysis, and hypnagogic or hypnopompic hallucinations (Dauvilliers et al., 2007). Besides sleep-related symptoms, regulation of emotion, cognitive impairments and mood disorder can be seen in narcolepsy (Naumann et al., 2006).Over the last two decades, numerous neuroimaging studies have investigated the pathophysiology of narcolepsy. Functional imaging studies showed metabolic (Joo et al., 2004) and perfusion (Joo et al., 2005) abnormalities in the hypothalamus-thalamus-orbitofrontal pathway and other brain areas in patients with narcolepsy, demonstrating alterations in the hypocretin pathway. Brain magnetic resonance imaging (MRI) studies in patients demonstrated distinct structural changes of multiple brain areas, accounting for problems in wake-sleep control, attention and memory ª

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Section: Discussionmentioning

confidence: 99%

White matter alterations in narcolepsy patients with cataplexy: tract‐based spatial statistics

Park

Kwon

Joo

et al. 2015

Journal of Sleep Research

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“…The earliest studies mostly showed intact memory and executive function (Aguirre and others 1985; Rogers and Rosenberg 1990). More recent research has revealed attention and executive function deficits that are consistent with subjective cognitive complaints from patients which impact their daily living (Moraes and others, 2012; Rieger and others 2003). Naumann and others (2006) observed impairment of attention and executive function, but preserved memory in narcoleptics.…”

Section: Clinical Features and Pathogenesis Of Narcolepsymentioning

confidence: 93%

Neuroimaging of Narcolepsy and Primary Hypersomnias

et al. 2020

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Advances in neuroimaging open up the possibility for new powerful tools to be developed that potentially can be applied to clinical populations to improve the diagnosis of neurological disorders, including sleep disorders. At present, the diagnosis of narcolepsy and primary hypersomnias is largely limited to subjective assessments and objective measurements of behavior and sleep physiology. In this review, we focus on recent neuroimaging findings that provide insight into the neural basis of narcolepsy and the primary hypersomnias Kleine-Levin syndrome and idiopathic hypersomnia. We describe the role of neuroimaging in confirming previous genetic, neurochemical, and neurophysiological findings and highlight studies that permit a greater understanding of the symptoms of these sleep disorders. We conclude by considering some of the remaining challenges to overcome, the existing knowledge gaps, and the potential role for neuroimaging in understanding the pathogenesis and clinical features of narcolepsy and primary hypersomnias.

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“…There is more-consistent evidence that patients with narcolepsy have attention and executive function deficits, which could explain their perceptions of memory deficits and, to some extent, their difficulties in some daily life activities (eg, driving). Most studies have reported slower reaction times and more-variable performances of patients with narcolepsy, relative to controls [15,[17][18][19]. In particular, changes in vigilance or in the ability to sustain attention are found in long, monotonous tasks [20].…”

Section: Introductionmentioning

confidence: 99%