Narcolepsy Flashcards
At what point in someone’s life does narcolepsy begin?
Usually begins in adolescence or early adulthood
What does narcolepsy mean?
The experience of sudden and uncontrollable attacks of sleep at irregular and unexpected times
What is associated with narcolepsy?
Cataplexy
What is cataplexy?
The loss of muscular control
What triggers episodes of narcolepsy?
Emotional arousal
What percentage of narcoleptics have cataplexy?
75%
Name 3 other symptoms of narcolepsy
1) Hallucination
2) Sleep paralysis
3) Frequent waking up
Name the 3 explanations of narcolepsy
1) REM
2) Immune system
3) Hypocretin
When was the REM explanation of narcolepsy created?
In the 1960s
Outline the REM explanation of narcolepsy
It is a result of the malfunction in the symptoms that maintain REM sleep
What evidence is there for the REM explanation of narcolepsy?
One of the symptoms of narcolepsy is cataplexy which is similar to what happens in REM sleep and during the day, sufferers often experience intrusions of REM-type sleep or hallucinations and at night, experience abnormal REM
Name and explain the 2 studies supporting the REM explanation of narcolepsy
1) Vogel (1960) - found REM occurred at the onset of sleep in narcoleptics which explains some symptoms like loss of muscle tone (found in REM) and hallucinations (REM-type sleep)
2) Siegel (1999) - recordings of neural activity in the brainstem of narcoleptic dogs - showed cataplexy co-occurred with brain cell activity that usually only occurs in REM - however general support not convincing
When was the immune system explanation of narcolepsy put forward?
In the 1980s
Outline the immune system explanation of narcolepsy
Narcolepsy is linked to a mutation of the immune system
Name the 3 research studies associated with the immune system explanation of narcolepsy
1) Honda (1983)
2) Stanford Medical Centre (2012)
3) Mignot (1997)
Outline Honda (1983)
Found increased frequency 1 type of human leukocyte antigen HLA which coordinate the immune response and found on the surface of white blood cells
Outline Stanford Medical Centre (2012)
Found more than 90% of narcoleptics with cataplexy found HLA varient - but not all so cannot be the only factor and it is not clear how HLA may lead to narcolepsy
Outline Mignot (1997)
The same HLA varient is reasonably common in the general population - so HLA varient cannot be the only cause
When was the hypocretin explanation of narcolepsy put forward?
In the 1990s
What is the role of hypocretin?
Maintaining wakefulness
What research study supports the role of hypocretin?
Sakurai (2007) - found hypocretin regulates sleep and wakefulness through interactions with systems which regulate emotion and homeostasis in the hypothalamus
How many hypocretin-producing cells are normally present in individuals?
10,000-20,000
What is a significant piece of evidence which supports the idea of hypocretin associated with narcolepsy?
In narcoleptics, a large number of hypocretin-producing cells are missing resulting in low levels of hypocretin
Name and explain 2 studies supporting the hypocretin explanation of narcolepsy
1) Lin (1999) - found narcoleptic dogs had mutation in gene on chromosome 12 which disrupted the way hypocretin is produced - findings confirmed in human studies
2) Nishino (2000) - found human narcoleptics had lower levels of hypocretin than normal in their cerebrospinal fluid