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Narcolepsy

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https://www.readbyqxmd.com/read/29047171/effectiveness-and-side-effect-profile-of-stimulant-therapy-as-monotherapy-and-in-combination-in-the-central-hypersomnias-in-clinical-practice
#1
Chiraag Thakrar, Kishankumar Patel, Grainne D'ancona, Brian D Kent, Alexander Nesbitt, Hugh Selsick, Joerg Steier, Ivana Rosenzweig, Adrian J Williams, Guy D Leschziner, Panagis Drakatos
Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively...
October 19, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/29036309/chiral-analysis-of-methamphetamine-in-oral-fluid-samples-a-method-to-distinguish-licit-from-illicit-drug-use
#2
Damon Borg, Elizabeth Kolb, Cindy Lantigua, Richard Stripp
Methamphetamine (MAMP) is a popular illicit drug abused for its central nervous system stimulating effects. MAMP is also used therapeutically in the treatment of overeating disorders, narcolepsy, attention deficit disorder, in over-the-counter (OTC) products to ease nasal congestion. MAMP exists in two enantiomeric forms, dextrorotary (d-MAMP) or levorotary (l-MAMP). The compounds are similar in chemical structure, simply differing in the orientation of functional groups around the asymmetric carbon. In part because of the availability of l-MAMP in OTC nasal inhalers, forensic guidelines require a sample to contain greater than 20% d-MAMP to consider illicit drug use when interpreting results...
September 25, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29031763/correlation-between-the-epworth-sleepiness-scale-and-the-maintenance-of-wakefulness-test-in-patients-with-narcolepsy-participating-in-two-clinical-trials-of-sodium-oxybate
#3
Milton Erman, Helene Emsellem, Jed Black, Fannie Mori, Geert Mayer
BACKGROUND: In evaluating pathologic sleepiness, the Epworth Sleepiness Scale (ESS) assesses subjective sleep propensity; the Maintenance of Wakefulness Test (MWT) is an objective measure of the ability to stay awake. This analysis evaluated the strength of the correlation between ESS and MWT with regard to absolute values in scores. METHODS: Data were analyzed separately from the intent-to-treat populations of two eight-week clinical trials of sodium oxybate for the treatment of narcolepsy, SXB-15 and SXB-22...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29031743/identifying-clinically-important-difference-on-the-epworth-sleepiness-scale-results-from-a-narcolepsy-clinical-trial-of-jzp-110
#4
Lawrence Scrima, Helene A Emsellem, Philip M Becker, Chad Ruoff, Alan Lankford, Gary Bream, Moise Khayrallah, Yuan Lu, Jed Black
BACKGROUND: While scores ≤10 on the Epworth Sleepiness Scale (ESS) are within the normal range, the reduction in elevated ESS score that is clinically meaningful in patients with narcolepsy has not been established. METHODS: This post hoc analysis of a clinical trial of patients with narcolepsy evaluated correlations between Patient Global Impression of Change (PGI-C) and ESS. Data of adult patients with narcolepsy from a double-blind, 12-week placebo-controlled study of JZP-110, a wake-promoting agent, were used in this analysis...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29029348/dysregulation-of-sleep-behavioral-states-in-narcolepsy
#5
Sarah F Schoch, Esther Werth, Rositsa Poryazova, Thomas E Scammell, Christian R Baumann, Lukas L Imbach
Study Objectives: Patients with narcolepsy suffer from poor maintenance of wakefulness and fragmented night sleep, but the underlying mechanism of sleep boundary dysregulation remains little understood. The goal of this study was to quantify abnormal sleep-wake regulation in narcolepsy patients. Methods: Using a model-based approach (state space analysis), we analyzed overnight EEG recordings in ten patients with narcolepsy type 1 and age- and gender-matched healthy control subjects...
October 5, 2017: Sleep
https://www.readbyqxmd.com/read/29023559/the-relationship-between-orexin-levels-and-blood-pressure-changes-in-patients-with-narcolepsy
#6
Mariusz Sieminski, Kamil Chwojnicki, Tomi Sarkanen, Markku Partinen
STUDY OBJECTIVE: Narcolepsy type 1 (NT1) is caused by a deficiency or absence of the neurotransmitter orexin. NT1 is also associated with a reduced nocturnal "dipping" of blood pressure (BP). The study objective was to analyze whether nocturnal BP values differed in patients depleted of orexin, versus those in whom production was preserved. METHODS: We performed a retrospective analysis of the polysomnographic recordings, orexin levels, and BP values of patients with NT1...
2017: PloS One
https://www.readbyqxmd.com/read/29019051/the-link-between-narcolepsy-and-autonomic-cardiovascular-dysfunction-a-translational-perspective
#7
REVIEW
Chiara Berteotti, Alessandro Silvani
Narcolepsy is a rare disease that entails excessive daytime sleepiness, often associated with sudden episodes of muscle weakness known as cataplexy. Narcolepsy with cataplexy (NC) is due to the loss of hypothalamic neurons that release the neuropeptides orexin A and B. Orexin neuron projections prominently target brain structures involved in wake-sleep state switching and the central autonomic network. This review provides an updated summary of the links between NC and autonomic cardiovascular dysfunction from a translational perspective...
October 10, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28991183/orexin-receptor-multimerization-versus-functional-interactions-neuropharmacological-implications-for-opioid-and-cannabinoid-signalling-and-pharmacogenetics
#8
Miles D Thompson, Takeshi Sakurai, Innocenzo Rainero, Mary C Maj, Jyrki P Kukkonen
Orexins/hypocretins are neuropeptides formed by proteolytic cleavage of a precursor peptide, which are produced by neurons found in the lateral hypothalamus. The G protein-coupled receptors (GPCRs) for these ligands, the OX₁ and OX₂ orexin receptors, are more widely expressed throughout the central nervous system. The orexin/hypocretin system has been implicated in many pathways, and its dysregulation is under investigation in a number of diseases. Disorders in which orexinergic mechanisms are being investigated include narcolepsy, idiopathic sleep disorders, cluster headache and migraine...
October 8, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28991006/autoimmunity-in-narcolepsy
#9
Melodie Bonvalet, Hanna M Ollila, Aditya Ambati, Emmanuel Mignot
PURPOSE OF REVIEW: Summarize the recent findings in narcolepsy focusing on the environmental and genetic risk factors in disease development. RECENT FINDINGS: Both genetic and epidemiological evidence point towards an autoimmune mechanism in the destruction of orexin/hypocretin neurons. Recent studies suggest both humoral and cellular immune responses in the disease development. SUMMARY: Narcolepsy is a severe sleep disorder, in which neurons producing orexin/hypocretin in the hypothalamus are destroyed...
November 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28990147/pandemrix%C3%A2-vaccination-is-not-associated-with-increased-risk-of-islet-autoimmunity-or-type-1-diabetes-in-the-teddy-study-children
#10
Helena Elding Larsson, Kristian F Lynch, Maria Lönnrot, Michael J Haller, Åke Lernmark, William A Hagopian, Jin-Xiong She, Olli Simell, Jorma Toppari, Anette-G Ziegler, Beena Akolkar, Jeffrey P Krischer, Marian J Rewers, Heikki Hyöty
AIMS/HYPOTHESIS: During the A/H1N1 2009 (A/California/04/2009) pandemic, mass vaccination with a squalene-containing vaccine, Pandemrix®, was performed in Sweden and Finland. The vaccination was found to cause narcolepsy in children and young adults with the HLA-DQ 6.2 haplotype. The aim of this study was to investigate if exposure to Pandemrix® similarly increased the risk of islet autoimmunity or type 1 diabetes. METHODS: In The Environmental Determinants of Diabetes in the Young (TEDDY) study, children are followed prospectively for the development of islet autoimmunity and type 1 diabetes...
October 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/28977300/analysis-of-daytime-sleepiniess-in-adolescents-by-the-pediatric-daytime-sleepiness-scale-a-systematic-review
#11
Carolina Meyer, Geraldo Jose Ferrari, Diego Grasel Barbosa, Rubian Diego Andrade, Andreia Pelegrini, Érico Pereira Gomes Felden
OBJECTIVE: To systematically review the use of the Pediatric Daytime Sleepiness Scale (PDSS) in the analysis of daytime sleepiness in children and adolescents. DATA SOURCE: The electronic databases PubMed and SciELO were consulted between 2003 and 2015. As inclusion criterion, studies were considered in English, Spanish and Portuguese, original articles of any type of design, articles with a sample of children and/or adolescents, articles that used the PDSS. Duplicate articles, articles with no relation to the theme, articles with another investigated population, and articles that the parents answered the instrument for their children were excluded...
July 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28977155/grey-zone-between-narcolepsy-type-1-and-type-2
#12
Gustavo Bruniera Fernandes, Renata Carvalho Cremaschi, Sérgio Tufik, Fernando Morgadinho Coelho
No abstract text is available yet for this article.
September 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28975007/the-medical-and-economic-burden-of-narcolepsy-implications-for-managed-care
#13
REVIEW
Michael J Thorpy, George Hiller
BACKGROUND: The neurologic disorder narcolepsy results from dysregulation of the sleep-wake cycle and is primarily characterized by chronic, severely excessive daytime sleepiness and cataplexy, an emotionally induced muscle weakness. The prevalence of narcolepsy is approximately 0.05%, and onset generally occurs during the first 2 decades of life. Narcolepsy is believed to be an autoimmune disorder with destruction of hypocretin-producing neurons in the lateral hypothalamus. OBJECTIVES: To provide an enhanced understanding of narcolepsy and establish the need for early diagnosis and rapid initiation of effective treatment for patients with narcolepsy...
July 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28969429/pediatric-narcolepsy-a-brief-report
#14
Blanka Klimova, Martin Valis, Marika Talabova, Jiri Kuchynka, Kamil Kuca
No abstract text is available yet for this article.
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28966744/human-hypocretin-deficient-narcolepsy-aberrant-food-choice-due-to-impaired-taste
#15
Giselle de Martin Truzzi, Renata Carvalho Cremaschi, Fernando Morgadinho Coelho
Authors demonstrate that patients with narcolepsy type 1 (N1) have more tendency of eat salty snacks after satiety than health volunteers. A few mechanisms to explain the weight gain have been discussed in narcolepsy. The hypocretin-1 deficiency can influence the olfactory system. The olfactory system should be modulated through hypocretin-1 via connections from the hypothalamic to other brain regions. Likewise, hypocretin-1 can be synthesized locally in our olfactory mucosa with possible private role modulating the olfactory...
April 2017: Sleep Science
https://www.readbyqxmd.com/read/28966734/current-and-future-treatment-options-for-narcolepsy-a-review
#16
Jackie Bhattarai, Scott Sumerall
Narcolepsy is a chronic neurological sleep disorder with potentially disabling symptoms ranging from occupational concerns to mental health difficulties. Recent advances related to the neurobiological basis of narcolepsy have led to newer pharmacological treatment options and adjunctive behavioral techniques that support symptom management. This article outlines evidence-based pharmacologic therapies, behavioral techniques, and psychosocial costs related to narcolepsy. Psychosocial factors, although frequently acknowledged, deserve further attention and awareness from researchers and providers...
January 2017: Sleep Science
https://www.readbyqxmd.com/read/28956242/polysomnographic-findings-in-craniopharyngioma-patients
#17
Line Pickering, Marianne Klose, Ulla Feldt-Rasmussen, Poul Jennum
PURPOSE: The purpose of this study is to evaluate whether damage to the hypothalamus due to craniopharyngioma or consequent surgery may involve the sleep-wake regulatory system, resulting in sleep disturbances and sleepiness. METHODS: Seven craniopharyngioma patients and 10 healthy controls were evaluated with sleep questionnaires including the Epworth Sleepiness Scale, polysomnography, and a multiple sleep latency test (MSLT). Five patients and eight controls had lumbar puncture performed to determine hypocretin-1 levels...
September 27, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28940143/narcolepsy-type-1-as-an-autoimmune-disorder-evidence-and-implications-for-pharmacological-treatment
#18
Lucie Barateau, Roland Liblau, Christelle Peyron, Yves Dauvilliers
Narcolepsy type 1 (NT1) is a rare sleep disorder caused by the very specific loss of hypothalamic hypocretin (Hcrt)/orexin neurons. The exact underlying process leading to this destruction is yet unknown, but indirect evidence strongly supports an autoimmune origin. The association with immune-related genetic factors, in particular the strongest association ever reported in a disease with an allele of a human leukocyte antigen (HLA) gene, and with environmental factors (i.e., the H1N1 influenza infection and vaccination during the pandemic in 2009) are in favor of such a hypothesis...
September 22, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28929470/-sleep-apnoea-hypopnoea-syndrome-and-narcolepsy-description-of-a-series-of-hospital-patients
#19
M J Abenza-Abildua, V Lores-Gutierrez, M T Ramirez-Prieto, A Miralles-Martinez, M Prieto-Palacio, G Cordero-Martin, C Algarra-Lucas, A Gomez-Acena, C Jimeno-Montero, G Gutierrez-Cueto, E Macon-Liquete, B Bathal-Guede, J A Garcia-De Gregorio, A Perez-Villena, M L Herreros-Fernandez, F J Arpa-Gutierrez
INTRODUCTION: Sleep disorders are highly prevalent among the general population, although very few cases of sleep apnoea-hypopnoea syndrome (SAHS) have been reported in patients with narcolepsy. This study reviews the sleep disorders found in patients with narcolepsy, the prevalence of SAHS associated with these patients and their response to the different treatments. PATIENTS AND METHODS: We conducted an observation-based retrospective descriptive analysis of 25 patients diagnosed with narcolepsy, who were treated in our centre between October 2012 and December 2016...
October 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28919446/increased-interferon-mediated-immunity-following-in-vitro-and-in-vivo-modafinil-treatment-on-peripheral-immune-cells
#20
Adriano Zager, Wesley Nogueira Brandão, Rafael Oliveira Margatho, Daniel Sanzio Gimenes Cruz, Jean Pierre Peron, Sergio Tufik, Monica Levy Andersen, Monica Moresco, Fabio Pizza, Giuseppe Plazzi, Birgitte Rahbek Kornum, João Palermo-Neto
The wake-promoting drug Modafinil has been used for treatment of sleep disorders, such as Narcolepsy, excessive daytime sleepiness and sleep apnea, due to its stimulant action. Despite the known effect of Modafinil on brain neurochemistry, particularly on brain dopamine system, recent evidence support an immunomodulatory role for Modafinil treatment in neuroinflammatory models. Here, we aimed to study the effects of in vitro and in vivo Modafinil treatment on activation, proliferation, cell viability, and cytokine production by immune cells in splenocytes culture from mice...
September 15, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
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