2021
DOI: 10.2147/nss.s300818
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Artificial Neural Networks Analysis of polysomnographic and clinical features in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): from sleep alteration to “Brain Fog”

Abstract: Study Objectives PANS (pediatric acute onset neuropsychiatric syndrome) is thought to be the result of several mechanisms and multiple etiologies, ranging from endocrine/metabolic causes to postinfectious autoimmune and neuroinflammatory disorders. Sleep disorders represent one of the most frequent manifestations of PANS, involving around 80% of patients. The present study describes the clinical and polysomnographic features in a group of PANS children identifying the relationships between sleep d… Show more

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Cited by 15 publications
(23 citation statements)
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“…A recent article by Gagliano et al emphasized the presence of sleep alterations in pediatric acute-onset neuropsychiatric syndrome (PANS), pointing out a symptomatic overlap with other sleep disorders of well-known immune-mediated pathogenesis, such as narcolepsy and Kleine-Levin syndrome. 1 While reading the article, I considered the potential role of orexin/hypocretin-system dysfunctionality in sleep disturbances for patients with PANS, alongside the development of other symptoms as part of this syndrome. Importantly, narcolepsy with cataplexy is caused by a loss of orexin-producing neurons in the hypothalamus, and orexin dysregulation has also been suggested to play a role in Kleine-Levin syndrome’s pathophysiology.…”
Section: Dear Editormentioning
confidence: 99%
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“…A recent article by Gagliano et al emphasized the presence of sleep alterations in pediatric acute-onset neuropsychiatric syndrome (PANS), pointing out a symptomatic overlap with other sleep disorders of well-known immune-mediated pathogenesis, such as narcolepsy and Kleine-Levin syndrome. 1 While reading the article, I considered the potential role of orexin/hypocretin-system dysfunctionality in sleep disturbances for patients with PANS, alongside the development of other symptoms as part of this syndrome. Importantly, narcolepsy with cataplexy is caused by a loss of orexin-producing neurons in the hypothalamus, and orexin dysregulation has also been suggested to play a role in Kleine-Levin syndrome’s pathophysiology.…”
Section: Dear Editormentioning
confidence: 99%
“… 4–8 In particular, obsessions and compulsive behaviors might be linked to the orexinergic system and its interactions with the dopaminergic system, 8 while the presence of orexin cells in the lateral hypothalamus, which is a key site of food intake regulation, 4 may relate to food restriction among patients with PANS. Considering Gagliano et al’s presentation of a putative dysfunctional model that explains the co-occurrence of sleep, cognitive, and motor symptoms in patients with PANS, 1 the orexin system’s role could be emphasized within this symptom’s framework.…”
Section: Dear Editormentioning
confidence: 99%
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