Symptomatic narcolepsy in patients with neuromyelitis optica and multiple sclerosis: New neurochemical and immunological implications

Takashi Kanbayashi, Takayoshi Shimohata, Ichiro Nakashima, Hiroaki Yaguchi, Ichiro Yabe, Masatoyo Nishizawa, Tetsuo Shimizu, Seiji Nishino

研究成果: Article

67 引用 (Scopus)

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Objective: To characterize factors that contribute to symptomatic narcolepsy and excessive daytime sleepiness in neuromyelitis optica and multiple sclerosis. Setting: Japanese university hospitals. Design: Case study. Patients: Seven Japanese patients whose initial diagnoses were multiple sclerosis and who were exhibiting excessive daytime sleepiness. Main Outcome Measures: Lesions on magnetic resonance imaging, cerebrospinal fluid hypocretin-1 levels, and serum anti-aquaporin 4 (AQP4) antibody titer. Results: Bilateral and symmetrical hypothalamic lesions associated with marked or moderate hypocretin deficiency were found in all 7 cases. Four of these patients met the International Classification of Sleep Disorders 2 narcolepsy criteria. Three patients, including 2 patients with narcolepsy, were seropositive for anti-AQP4 antibody and diagnosed as having neuromyelitis optica - related disorder. Conclusion: Since AQP4 is highly expressed in the hypothalamic periventricular regions, an immune attack on AQP4 may be partially responsible for the bilateral and hypothalamic lesions and hypocretin deficiency in narcolepsy/ excessive daytime sleepiness associated with autoimmune demyelinating diseases.

元の言語English
ページ(範囲)1563-1566
ページ数4
ジャーナルArchives of Neurology
66
発行部数12
DOI
出版物ステータスPublished - 2009 12

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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    Kanbayashi, T., Shimohata, T., Nakashima, I., Yaguchi, H., Yabe, I., Nishizawa, M., Shimizu, T., & Nishino, S. (2009). Symptomatic narcolepsy in patients with neuromyelitis optica and multiple sclerosis: New neurochemical and immunological implications. Archives of Neurology, 66(12), 1563-1566. https://doi.org/10.1001/archneurol.2009.264