Narcolepsy
New England Journal of MedicinePublished 9 August 1990
Jane F. Desforges, Michael S. Aldrich
Citations94
SJR quartileQ1
SJR score19.08
SNIP13.47
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
NARCOLEPSY, a syndrome of excessive sleepiness and abnormalities of rapid-eye-movement (REM) sleep,1 is a distinct neurologic disorder with characteristic clinical symptoms and sleep-laboratory findings. Narcolepsy associated with cataplexy is often called "classic narcolepsy." There have been several important advances in understanding narcolepsy since the last review in the Journal.2 Narcolepsy is strongly linked to certain Class II HLA antigens, indicating the presence of a "narcolepsy-susceptibility" gene on chromosome 6. Pharmacologic and pathological studies of human and canine narcolepsy have demonstrated abnormalities of monoaminergic and cholinergic functioning in the brain. The objective assessment of sleepiness and the onset of REM . . .
Keywords
Neuroscience
Electroencephalography and Clinical NeurophysiologyExcessive daytime sleepiness in man: Multiple sleep latency measurement in narcoleptic and control subjects
458 Citations1978Gary S. Richardson, Mary A. Carskadon +4 more
It is concluded that the Multiple Sleep latency test, in addition to providing opportunities to clinically document sleep onset REM sleep periods, can demonstrate pathological sleepiness.
Tissue AntigensHLA antigens in Japanese patients with narcolepsy
372 Citations1984Takeo Juji, Masahiro Satake +2 more
A surprisingly high association between an HLA-DR locus antigen and narcolepsy was revealed in the Japanese, and data suggested that a "disease" allele predisposing to narcoLEpsy was inherited with relatively rare haplotypes with DR2 in theJapanese.
SLEEPAutomobile Accidents in Patients with Sleep Disorders
351 Citations1989Michael S. Aldrich
Patients with a wide variety of sleep disorders appear to be at increased risk for sleep-related accidents, and the severity and duration of hypersomnia are probably not the only factors that contribute to that risk.
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences NeurologiquesLife Effects of Narcolepsy in 180 Patients from North America, Asia and Europe Compared to Matched Controls
234 Citations1981Roger Broughton, Quais Ghanem +4 more
Narcolepsy can produce a variety of life-effects probably more serious and pervasive than, for instance, those of epilepsy, therefore emphasizing the importance of early diagnosis and treatment.
SLEEPTreatment of Narcolepsy with γ-Hydroxybutyrate. A Review of Clinical and Sleep Laboratory Findings
233 Citations1986Mortimer Mamelak, Martin B. Scharf +1 more
It is noteworthy, therefore, that the central biochemical changes induced by GHB also appear comparable to those found naturally in narcolepsy.
The LancetGENETIC MARKERS IN NARCOLEPSY
216 Citations1984Nicola Langdon, MiekeVan Dam +3 more
This work has confirmed the genetic basis for narcolepsy, and furthermore links it with the short arm of chromosome 6, and found the strongest HLA-disease association so far discovered.
NeurologyCerebral hyperemia, stroke, and transfusion in sickle cell disease
153 Citations1989I. Prohovnik, Steven G. Pavlakis +5 more
Findings document a vasodilatory hyperemia in SCD, which may be a risk factor for ischemic distal-field infarctions, as visualized by MRI, due to a limitation of cerebrovascular reserve capacity.
SLEEPExcessive Daytime Sleepiness and the Pathophysiology of Narcolepsy-Cataplexy: A Laboratory Perspective
142 Citations1986Roger Broughton, Victoria Valley +4 more
It is argued that in pathophysiological terms narcolepsy may best be considered a disease of state boundary control.
Electroencephalography and Clinical NeurophysiologyREM sleep episodes during the multiple sleep latency test in narcoleptic patients
142 Citations1979Merrill M. Mitler, Johanna Van den Hoed +5 more
The Multiple Sleep Latency Test can provide physicians with data useful in the diagnosis of narcolepsy, and it is concluded that this procedure can receive physicians' approval.
Electroencephalography and Clinical NeurophysiologyAmbulatory 24 hour sleep-wake monitoring in narcolepsy-cataplexy compared to matched controls
135 Citations1988Roger Broughton, Wayne Dunham +4 more
Nocturnal sleep of narcoleptics was similar to descriptions of laboratory based recordings and was characterized by frequent sleep onset REM periods, high variability of REM latency, increased amounts of wakefulness after sleep onset, and low sleep efficiencies.
Archives of NeurologyNarcolepsy-Cataplexy
131 Citations1982Anthony Kales
The emotional and psychosocial correlates of narcoleptic patients showed high levels of psychopathology compared with controls, but this difference is considered to be primarily a reaction to the disorder and its effects.
NeurologyNarcolepsy associated with lesions of the diencephalon
130 Citations1989Michael S. Aldrich, Michael W. Naylor
It is suggested that diencephalic lesions can be associated with signs and symptoms of narcolepsy that are clinically indistinguishable from those of idiopathic narcolypsy, and that the HLA-DR2 antigen is not required in all cases of symptomatic narcoLEpsy.
Electroencephalography and Clinical NeurophysiologyElectroencephalographic study on narcolepsy
128 Citations1965Yasuo Hishikawa, Ziro Kaneko
The basic disturbances characterizing narcoleptics are a persistent and intense inclination to fall in sleep and to fall into the REM period of sleep directly from wakefulness and at the sleep onset.
SLEEPHLA-DR2 and Dw2 in Narcolepsy and in Other Disorders of Excessive Somnolence Without Cataplexy
110 Citations1986Yutaka Honda, Takeo Juji +7 more
It was concluded that HLA-DR2 is a prerequisite for the development of narcolepsy and that the diagnosis of nar colepsy can be excluded if HLA/Dw2 is negative, and the distinction between idiopathic and symptomatic narCOlepsy needs to be reconsidered.
Electroencephalography and Clinical NeurophysiologyThe physiological (EEG) nature of drowsiness and its relation to performance deficits in narcoleptics
106 Citations1983Victoria Valley, Roger Broughton
The results clarify the temporal pattern of physiological vigilance during performance in narcoleptics and also demonstrate the insufficiency of the lapse-microsleep formulation in explaining performance deterioration in these patients.
ScienceNarcolepsy: Biogenic Amine Deficits in an Animal Model
104 Citations1983Ivan N. Mefford, Theodore L. Baker +5 more
Concentrations of biogenic amine metabolites in discrete brain areas differed significantly between dogs with genetically transmitted narcolepsy and age- and breed-matched controls, indicating a nonglobal depression of dopamine utilization or turnover or both.
Experimental NeurologyCholinergic mechanisms and cataplexy in dogs
95 Citations1979John B. Delashaw, Arthur S. Foutz +2 more
The results of this study suggest that central muscarinic cholinergic receptors are critically involved in the mechanism which produces the motor inhibition of cataplexy.
NeurologyNarcolepsy and idiopathic hypersomnia
89 Citations1982Jacques Montplaisir, Jacques de Champlain +5 more
The concentrations of DA and IAA, a metabolite of tryptamine, were significantly decreased in the CSF of both groups of hypersomniacs.
Electroencephalography and Clinical NeurophysiologyA syndrome of hypersomnia with automatic behavior
89 Citations1975Christian Guilleminault, Robert L. Phillips +1 more
Five male patients, complaining of daytime sleep attacks, and hav ing a history of automatic behavior, were recorded continously by polygraph for 108 h under two different protocols: (1ents were given specific tests to perform during Phase 1 and six normal males were run as controls during Phase .
NeurologyHLA antigens in narcolepsy
87 Citations1987Sara Neely, R A Rosenberg +3 more
Eighteen black patients with narcolepsy underwent human leukocyte antigen (HLA) typing and found eleven of the 18 had cataplexy, and all patients had DQwl, in contrast to white and Japanese patients studied to date.
Electroencephalography and Clinical NeurophysiologySleep studies on canine narcolepsy: Pattern and cycle comparisons between affected and normal dogs
81 Citations1977Merrill M. Mitler, William C. Dement
Results indicated that narcoleptic dogs do not differ from normals with respect to percent of time spent in wakefulness and atonia with no theta, and normal dogs presented neither of these pathological states.
Life SciencesNarcolepsy: Cholinergic receptor changes in an animal model
81 Citations1984Richard Boehme, Theodore L. Baker +4 more
The increased receptor levels found in the brainstem suggest that cholinoceptive neurons in this region are hypersensitive and may be involved in the initiation of cataplexy and other aspects of the narcolepsy syndrome.
NeurologyContinuous cataplexy in a patient with a midbrain tumor
73 Citations1980Stephen M. Stahl, Robert B. Layzer +3 more
A patient with glioblastoma of the rostral brainstem and hypothalamus exhibited bilateral internuclear ophthalmoplegia and vertical nystagmus; he suffered episodes of cataplexy, narcolepsy, and sleep paralysis.
ImmunogeneticsMHC class II sequences of an HLA-DR2 narcoleptic
67 Citations1988Christopher Lock, A K So +3 more
It is concluded that there are probably no narcolepsy-specific DRβ or DQ α/β sequences, and that the alleles found in nar colepsy are representative of those found in the healthy population.
SLEEPAlerting Effects of Naps in Patients with Narcolepsy
60 Citations1986Timothy Roehrs, Frank Zorick +4 more
While narcoleptic patients showed no change in latency as a function of increased nap duration, the other DOES patients had increased latencies, and when tested 30 min after a 15-min nap, narcoelptic patients had latencies that did not differ from those of tests 1-4, while the otherDoes patients sustained their increased latency.
CHEST JournalNeurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain Irradiation
57 Citations1988Israel Rubinstein, Trevor A. Gray +2 more
Treatment with high-dose corticosteroids was ineffective, but when the low-dose, whole-brain irradiation was added, complete resolution of the narcoleptic features ensued.
Brain ResearchBrain dopamine receptor levels elevated in canine narcolepsy
54 Citations1987S. Scott Bowersox, Thomas S. Kilduff +4 more
D dopamine D2 receptors in discrete brain areas differed significantly between dogs with the genetically transmitted form of narcolepsy, and age- and breed-matched controls, pointing to impaired dopamine release as a possible etiologic factor.
Acta Neurologica ScandinavicaMazindol in the treatment of narcolepsy
53 Citations2009J. D. Parkes, M Schachter
Treatment with mazindol 3‐8 mg daily for 1 year caused a sustained improvement in narcolepsy, but had no effect on cataplexy or sleep paralysis.
SLEEPExacerbation of Human Cataplexy by Prazosin
51 Citations1989Michael S. Aldrich, Ann E. Rogers
Findings are similar to the reported effects of prazosin on cataplexy in narcoleptic dogs; they support a role for altered alpha 1-adrenoceptor function inNarcolepsy.
SLEEPDiagnosis of Narcolepsy Using the Multiple Sleep Latency Test: Analysis of Current Laboratory Criteria
50 Citations1985Stephen A. Amira, Tamara Johnson +1 more
It was concluded that the MSLT is a highly reliable laboratory tool for the confirmation of the diagnosis of narcolepsy based on the SOREMP criterion.
Brain ResearchEffect of α1-adrenoceptors blockade with prazosin in canine narcolepsy
50 Citations1988Emmanuel Mignot, Christian Guilleminault +3 more
It is suggested that central α1-adrenoceptors play a fundamental role in controlling mechanisms involved in cataplexy and REM sleep.
Electroencephalography and Clinical NeurophysiologyREM sleep and NREM sleep in narcolepsy and hypersomnia
50 Citations1969B Roth, S Brůhová +1 more
The authors consider cataplexy, sleep paralysis and hypnagogic hallucinations as dissociated manifestations of REM sleep, as well as all kinds of hypersomnia, is due to a disturbance of the NREM sleep system.
Electroencephalography and Clinical NeurophysiologyH-reflex and EMG of the mental and hyoid muscles during sleep, with special reference to narcolepsy
48 Citations1965Yasuo Hishikawa, N Sumitsuji +2 more
It is concluded that sleep paralysis is not a part of the hypnagogic hallucinations often experienced by narcoleptics but a real experience of paralysis resulting from a dissociation between the level of consciousness and the somatic muscle and reflex activities in the sleep onset REM period.
Clinical Immunology and ImmunopathologyHLA-DR2 association with excessive somnolence in narcolepsy does not generalize to sleep apnea and is not accompanied by systemic autoimmune abnormalities
47 Citations1988Robert L. Rubin, Roza M. Hajdukovich +1 more
If narcolepsy is an autoimmune disease, the underlying lesion or pathologic condition may be confined to the central nervous system, and the absence of laboratory signs and clinical features of a systemic inflammatory process are indicated.
Annals of NeurologyMonoaminergic mechanisms and experimental cataplexy
47 Citations1981Arthur S. Foutz, John B. Delashaw +2 more
The suppression of cataplexy induced by nisoxetine or protriptyline was reversed by the anticholinesterase physostigmine, further supporting a postulated aminergic‐cholinergic interaction in the mechanisms for catAPlexy.
SLEEPSelegiline in Narcolepsy
42 Citations1986S. E. Roselaar, Nicola Langdon +3 more
The effect of selegiline, 20-30 mg p.o. daily, on alertness and mood was similar to that of dexamphetamine in the same dosage, with comparable sympathomimetic side effects.
Journal of Neurology Neurosurgery & PsychiatryAutonomic control of cardiovascular reflexes in narcolepsy.
41 Citations1980Bernhardt Sachs, L. Kaijser
It is concluded that narcolepsy is accompanied by reduced vegetative reactivity in the cardiovascular system, and this applies to functions mediated by both the sympathetic and parasympathetic systems.
NeurologyMonozygotic twins concordant for the narcoleptic syndrome
40 Citations1989Alan B. Douglass, Lyndsay Harris +1 more
The first documented monozygotic twins who both had the narcoleptic syndrome have been reported, and monozygosity by HLA antigens and by blood groups is assessed.
SLEEPDaytime Sleep Characteristics and their Relationships with Night Sleep in the Narcoleptic Patient
38 Citations1986Michel Billiard, Quera M. Salva +4 more
The results are interpreted as evidence that the daytime sleep of narcoleptic patients is modified, similar to their night sleep, and that SOREM episodes are influenced by a time-of-day effect which culminates between 1200 and 1400 h.
SLEEPSerotoninergic Reuptake Mechanisms in the Control of Cataplexy
36 Citations1986Jacques Montplaisir, Roger Godbout
The results suggest that 5-HT neuronal systems are involved in the physiopathology of cataplexy, and the mechanisms of action of other anticataplectic agents are discussed.
Journal of Neurology Neurosurgery & PsychiatrySymptomatic cataplexy.
33 Citations1977M Anderson, M V Salmon
A man who developed attacks of cataplexy, narcolepsy, and sleep paralysis because of microglioma which infiltrated the walls and floor of the IIIrd ventricle and the upper brain stem is described.
Annals of the New York Academy of SciencesNarcolepsy and HLA in the Japanese
32 Citations1988Takeo Juji, K Matsuki +3 more
HLA-Dw2 is the better marker of the HLA-associating narcoleptic gene than is DR2, DQw1, 2.4-kb band of EcoRI-digested DQ beta, and 6.0- kb band of Taq I digested D Q alpha, because the frequency of DW2 isThe lowest in normal control subjects.
SLEEPNarcolepsy: A Neuropathologic Study
32 Citations1986Stephanie S. Erlich, Hideo H. Itabashi
There is no evidence that the narcoleptic symptoms of this patient were secondary to any other disorder, including the arachnoid cyst, and this patient's symptoms may be related to the pontine and hypothalamic gliosis, the etiology for which is unknown.
Human ImmunologyNo difference in the nucleotide sequence of the DQß ß1 domain between narcoleptic and healthy individuals with DR2,Dw2
28 Citations1989Noboru Uryu, Masahiro Maeda +8 more
No difference in sequence could be found between narcoleptic and healthy individuals, suggesting thatNarcolepsy is not due to mutation in the DQ beta gene, and a possible role of the HLA class II antigens in narcoLEpsy is discussed.
SLEEPPropranolol: Long-Term Treatment in Narcolepsy-Cataplexy
22 Citations1985K. Meier‐Ewert, K Matsubayashi +1 more
The initial effectiveness of propranolol on daytime sleepiness appeared to be good to very good; in these patients the effects seemed comparable to that of pemoline; within 6 months, however, the effectiveness started to decrease, and after 26 months only 8% (2 out of 24) of those patients taking the single drug were satisfied with proPRanolol therapy alone.
The LancetTREATMENT OF NARCOLEPSY WITH L-TYROSINE
19 Citations1988J Mouret, Patrick Sanchez +4 more
8 patients with narcolepsy treated with oral tyrosine within six months all were free from daytime sleep attacks and cataplexy.
Psychiatric Clinics of North AmericaClinical, Neuroendocrine, and Sleep EEG Diagnosis of "Unusual" Affective Presentations: A Practical Review
16 Citations1983Hagop S. Akiskal, Hélio Lemmi
It is believed that the emerging laboratory technology, if interpreted in the context of clinical findings, may assist in differential diagnostic decisions on difficult boundary issues surrounding affective disorders.
ImmunogeneticsTaq I-generated HLA-DQ ?polymorphism in Japanese patients with narcolepsy
12 Citations1988Kazumasa Matsuki, Hiroo Maeda +5 more
Findings suggest that a narcolepsy-susceptibility gene is located closer to the DQ locus than to the DX locus, and this finding added the D Q alpha gene to the list of candidates for the possible narcoLEpsy-Susceptible gene.
Human ImmunologyCellular approach for detecting narcolepsy-specific alterations in DR2 haplocytes
11 Citations1988P. Strohmaier, G. Mueller‐Eckhardt +1 more
It is concluded that narcolepsy-specific alterations of class II molecules cannot be cellularly detected or do not exist on peripheral lymphocytes.
Archives of NeurologyObjective Assessment of Narcolepsy
7 Citations1983Michael J. Thorpy, Daniel Wagner +2 more
The authors stated that the presence of cataplexy allows the physician to proceed with treatment "solely on the basis of the clinical picture, without sleep laboratory evaluation."
American Journal of OphthalmologyOphthalmic Manifestations of Narcolepsy
6 Citations1987Matthew E. Norman, John A. Dyer
The records of 755 patients in whom narcolepsy was diagnosed between 1979 and 1983 were reviewed, and the following variables were assessed: the subspecialty in which the condition was diagnosed, age and sex of the patients, family history, expressed symptoms in the total group.