Narcolepsy–cataplexy associated with precocious puberty

Plazzi, Giuseppe; Parmeggiani, Antonia; Mignot, Emmanuel; Lin, Liu; Scano, Martina; Posar, Annio; Bernardi, Filippo; Lodi, Raffaele; Tonon, Caterina; Barbiroli, Bruno; Montagna, Pasquale; Cicognani, A

doi:10.1212/01.wnl.0000216142.21375.71

Cited by 58 publications

(32 citation statements)

References 8 publications

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“…A lack of hypocretin-1, as seen in children with narcolepsy leads to obesity and precocious puberty. 50 This suggests that changes in hypothalamic functioning, such as disturbed hypocretin-1 signaling, might lead to disturbance of the circadian cycle and feeding behavior, affecting energy balance and body composition over time. 48,49 The possibility that disturbed hypothalamic functioning may explain the relationship between the changes in BMI and in sleep duration during puberty is underscored by altered hormone concentrations.…”

Section: Discussionmentioning

confidence: 99%

Sleep duration and body-weight development during puberty in a Dutch children cohort

et al. 2010

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Background: Short sleep duration is associated with obesity during childhood and adulthood. Objective: The objective of our study was to investigate the relationship between sleep duration and body mass index (BMI) from Tanner stages 1 to 5 in a Dutch children cohort. Design: In 98 children, anthropometric measurements and leptin concentrations were measured from age 7 to 16 years; body composition, physical activity (Baecke questionnaire), hours television viewing and self-reported sleep duration were measured yearly from age 12 to 16 years. Moreover, the polymorphisms of the FTO gene (rs9939609) and parental BMI's were determined. Results: At Tanner stages 1-5 sex differences were observed in height, body weight, waist circumference, fat mass per squared meter height and leptin concentrations per kg fat mass. Inverse relationships were observed between the change in BMI (kg m -2 ) and the change in hours of sleep per night (h) from Tanner stages 1 to 4 (r ¼ À0.68, Po0.001), from Tanner stages 2 to 5 (r ¼ À0.35, Po0.05) and from Tanner stages 1 to 5 (r ¼ À0.33, Po0.05). Univariate analysis of variance showed that with progressive Tanner stages, BMI increases and sleep duration decreases in an interrelated way independent of possible confounders (R 2 ¼ 0.38, Po0.02). Conclusion: Changes in BMI during puberty were inversely related to changes in sleep duration, independent of possible confounders.

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Section: Discussionmentioning

confidence: 99%

Sleep duration and body-weight development during puberty in a Dutch children cohort

et al. 2010

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“…There are case reports on precocious puberty and narcolepsy-cataplexy. 33 While pubertal stage could be more rigorously determined in future trials, the cost-effectiveness, as well as cultural implications, of a physical examination of a child for Tanner Stage does not appear to be high, compared to weight change or sleep symptoms, for an epidemiologic study.…”

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confidence: 99%

Presentations of Primary Hypersomnia in Chinese Children

Han

et al. 2011

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627Childhood Narcolepsy/Hypersomnia-Han et al on the pediatric population could help address issues related to puberty, genetic predisposition, and environmental triggers, and possibly shed light on factors that might delay diagnosis. We report on findings from a pediatric cohort of patients who presented with primary hypersomnia to a sleep clinic in Beijing, China over a period of ~10 years. All were evaluated in a standard fashion and classified as narcolepsy with or without cataplexy or idiopathic hypersomnia. Our purpose was to describe age of onset and clinical features of primary hypersomnia among a mainland Chinese cohort of children, and to compare the findings to the literature. METHODS PatientsPatients were children, defined as < 18 years of age, successively presenting with hypersomnia seen over a period of ~10 years (September, 1998 to May, 2009) at People's Hospital, Beijing University, Beijing. A total of 417 children (63%) were drawn from a population of 671 adults and children with hypersomnia. The hospital has a pulmonary medicine departmentbased sleep center, which sees both children and adults, and receives referrals from all of mainland China. It is estimated that 70% of the diagnosed narcolepsy patients in mainland China are seen at this center at People's Hospitals.12 A prior report focused on the impact of a narcolepsy recognition strategy in a pediatric neurology clinic, 13 whereas this report retrospectively describes a cohort with a broader symptom profile, evaluated using a stan- INTRODUCTIONNarcolepsy-cataplexy (NC) occurs worldwide. In China, there is a population prevalence of 0.034% in patients in South China presenting to sleep centers in Hong Kong 1,2 and a prevalence of 0.014% in Korean adolescents with similar clinical and biological presentations.3-5 Studies in North America and Europe estimates are similar. As the origin and mechanisms that produce narcolepsy are not well understood, comparisons of clinical presentations in collections of several characterized patient groups can inform future studies of clinical and genetic epidemiology.Narcolepsy-cataplexy is said to present in the second to third decade of life, with 70% to 80% of patients reporting onset between 10-20 years of age. Large sample size observations from the United States, Canada, Europe, and Japan report that half of adult patients with narcolepsy report narcolepsy onset prior to 15 years old, and only exceptionally at 5 or younger.6-9 Studies in the 1980s-1990s reported a median delay > 10 years between onset and diagnosis, 10 whereas a more recent report suggests the delay can be only a few years, particularly in children.11 A focus Objective: To retrospectively describe childhood presentations of primary hypersomnia with an emphasis on narcolepsy-cataplexy in a Chinese population. Methods: A total of 417 children (< 18 years old) successively presenting with complaints of hypersomnia without anatomic cause or sleep apnea risk were evaluated using the Stanford Sleep Inventory, human leukocyte antigen (HLA) ...

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“…The advanced onset in the present sample may be putatively related to earlier puberty [31]. An association between puberty onset and narcolepsy has been suspected earlier [2,32,34]. Unfortunately, this also implies that narcolepsy symptoms may be interpreted as a puberty-related phenomenon.…”

Section: Discussionmentioning

confidence: 57%