Impact of Obesity in Children with Narcolepsy

Inocente, Clara Odília; Lavault, Sophie; Lecendreux, Michel; Dauvilliers, Yves; Reimão, Rubens; Gustin, Marie-Paule; Castets, Sarah; Spiegel, Karine; Lin, Jian‐Sheng; Arnulf, Isabelle; Franco, Patricia

doi:10.1111/cns.12105

Cited by 78 publications

(58 citation statements)

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“…All narcoleptic patients were CSF hypocretin‐1‐deficient and all were positive for HLA‐ DQB1*06:02. None had secondary narcolepsy; (d) as we have reported previously, there are very few narcoleptic children in our cohort presenting obstructive sleep apnea syndrome . In this study, the median obstructive apnea/hypopnea index (OAHI) was 0.6/hours (range from 0 to 6.4/hours).…”

Section: Methodssupporting

confidence: 60%

Impaired histaminergic neurotransmission in children with narcolepsy type 1

et al. 2018

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Section: Methodssupporting

confidence: 60%

Impaired histaminergic neurotransmission in children with narcolepsy type 1

et al. 2018

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“…In addition to the core symptoms of narcolepsy, affected children have higher rates of obesity, 3 depressive symptoms, 4 and attention deficit/hyperactivity disorder symptoms, 5 which in turn results in substantially reduced quality of life 6 and academic performance for these children. 7,8 Current treatment options in narcolepsy remain limited to symptomatic treatment with psychostimulants and anticataplectic agents.…”

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confidence: 99%

Intravenous Immunoglobulin Therapy in Pediatric Narcolepsy: A Nonrandomized, Open-Label, Controlled, Longitudinal Observational Study

Lecendreux

Berthier

Corny

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Previous case reports of intravenous immunoglobulins (IVIg) in pediatric narcolepsy have shown contradictory results. Methods: This was a nonrandomized, open-label, controlled, longitudinal observational study of IVIg use in pediatric narcolepsy with retrospective data collection from medical files obtained from a single pediatric national reference center for the treatment of narcolepsy in France. Of 56 consecutively referred patients with narcolepsy, 24 received IVIg (3 infusions administered at 1-mo intervals) in addition to standard care (psychostimulants and/or anticataplectic agents), and 32 continued on standard care alone (controls). Results: For two patients in each group, medical files were unavailable. Of the 22 IVIg patients, all had cerebrospinal fluid (CSF) hypocretin ≤ 110 pg/mL and were HLA-DQB1*06:02 positive. Of the 30 control patients, 29 were HLA-DQB1*06:02 positive and of those with available CSF measurements, all 12 had hypocretin ≤ 110 pg/mL. Compared with control patients, IVIg patients had shorter disease duration, shorter latency to sleep onset, and more had received H1N1 vaccination. Mean (standard deviation) follow-up length was 2.4 (1.1) y in the IVIg group and 3.9 (1.7) y in controls. In multivariate-adjusted linear mixed-effects analyses of change from baseline in Ullanlinna Narcolepsy Scale (UNS) scores, high baseline UNS, but not IVIg treatment, was associated with a reduction in narcolepsy symptoms. On time-to-event analysis, among patients with high baseline UNS scores, control patients achieved a UNS score < 14 (indicating remission) less rapidly than IVIg patients (adjusted hazard ratio 0.18; 95% confidence interval: 95% confidence interval: 0.03, 0.95; p = 0.043). Shorter or longer disease duration did not influence treatment response in any analysis. Conclusions: Overall, narcolepsy symptoms were not significantly reduced by IVIg. However, in patients with high baseline symptoms, a subset of IVIgtreated patients achieved remission more rapidly than control patients. I NTRO DUCTI O NNarcolepsy is a debilitating and currently an incurable neurological condition with a characteristic constellation of symptoms, including excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic hallucinations, and disturbed nocturnal sleep.Until recently, and at the time patients in this study were treated, the disorder was categorized into narcolepsy with cataplexy and narcolepsy without cataplexy according to the revised second edition of the International Classification of Sleep Disorders (ICSD).1 ICSD-2-revised has now been replaced by ICSD-3, which classifies narcolepsy into type 1 and type 2 narcolepsy. 2The majority of patients with type 1 narcolepsy have hypocretin deficiency (cerebrospinal fluid [CSF] hypocretin-1 level ≤ 110 pg/ mL), which is considered to result from an autoimmune-mediated loss of hypocretin-secreting neurons in those who are genetically predisposed (most commonly those with human leucocyte antigen [HLA] DQB1*06:02 haplotype). The...

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“…Obesity affects more than half of childhood narcoleptic cases [17]. Paediatric narcolepsy-cataplexy is also associated with excessive weight gain prior to symptom onset, and may be associated with other sleep disorders, including periodic limb movements and sleep apnoea, which may obscure or delay the correct clinical diagnosis [18].…”

Section: Discussionmentioning

confidence: 99%

Quickly diagnosed and treated prepubertal Type 1 narcolepsy case

Çökmüş

Aydın

Di̇ki̇ci̇³

et al. 2017

Psychiatry and Clinical Psychopharmacology

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Excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucination are the classic tetrad of narcolepsy. It has been shown that narcolepsy, a chronic and disabling disease, starts in childhood and adolescence rather than adulthood. The International Classification of Sleep Disorder (ICSD-3) classifies narcolepsy into Type 1 (narcolepsy with cataplexy) and Type 2 (narcolepsy without cataplexy). There is low awareness and knowledge of narcolepsy among the general public, primary care physicians, and sleep specialists. It has been shown that the lack of recognition of disease symptoms delayed the diagnosis of narcolepsy from 8.7 to 22.1 years. In this case report, we will discuss the case of Type 1 narcolepsy, which started in the prepubertal period and was diagnosed and treated in a short period of time. ARTICLE HISTORY

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Impact of Obesity in Children with Narcolepsy

Abstract: Obesity affects more than 50% of narcoleptic children, mostly younger at disease onset, and has a deleterious impact on sleep quality as well as on school attendance.

Cited by 78 publications

References 50 publications

Impaired histaminergic neurotransmission in children with narcolepsy type 1

Impaired histaminergic neurotransmission in children with narcolepsy type 1

Intravenous Immunoglobulin Therapy in Pediatric Narcolepsy: A Nonrandomized, Open-Label, Controlled, Longitudinal Observational Study

Quickly diagnosed and treated prepubertal Type 1 narcolepsy case

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