Abnormal Regional Spontaneous Neural Activity and Functional Connectivity in Unmedicated Patients with Narcolepsy Type 1: A Resting-State fMRI Study

Lanxiang Wu, Qingqing Zhan, Qian Liu, Suheng Xie, Sheng Tian, Liang Xie () and Wei Wu ()
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Lanxiang Wu: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Qingqing Zhan: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Qian Liu: Imaging Department, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Suheng Xie: Imaging Department, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Sheng Tian: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Liang Xie: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Wei Wu: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

IJERPH, 2022, vol. 19, issue 23, 1-14

Abstract: Background: Previous Resting-state functional magnetic resonance imaging (fMRI) studies have mainly focused on cerebral functional alteration in processing different emotional stimuli in patients with narcolepsy type 1 (NT1), but were short of exploration of characteristic brain activity and its remote interaction patterns. This study aimed to investigate the spontaneous blood oxygen fluctuations at rest and to elucidate the neural mechanisms underlying neuropsychiatric behavior. Method: A total of 18 unmedicated patients with NT1 and matched healthy individuals were recruited in a resting-state fMRI study. Magnetic resonance imaging (MRI) data were first analyzed using fractional low-frequency amplitude of low-frequency fluctuation (fALFF) to detect changes in local neural activity, and regions with group differences were taken as regions of interest (ROIs). Secondly, functional connectivity (FC) analysis was used to explore altered connectivity between ROIs and other areas. Lastly, the relationship between functional brain activity and neuropsychiatric behaviors was analyzed with correlation analysis. Results: fALFF analysis revealed enhanced neural activity in bilateral fusiform gyrus (FFG), right precentral gyrus, and left postcentral gyrus (PoCG) in the NT1 group. The patients indicated reduced activity in the bilateral temporal pole middle temporal gyrus (TPOmid), left caudate nucleus (CAU), left parahippocampus, left precuneus (PCUN), right amygdala, and right anterior cingulate and paracingulate gyri. ESS score was negatively correlated with fALFF in the right FFG. The NT1 group revealed decreased connectivity between left TPOmid and right PoCG, the bilateral middle frontal gyrus, left superior frontal gyrus, medial, and right supramarginal gyrus. Epworth Sleepiness Scale (ESS) was negatively correlated with FC of the left TPOmid with left putamen (PUT) in NT1. Compared with healthy controls (HCs), enhanced FC of the left CAU with right FFG was positively associated with MSLT-SOREMPs in patients. Furthermore, increased FC of the left PCUN with right PoCG was positively correlated with SDS score. Conclusions: We found that multiple functional activities related to the processing of emotional regulation and sensory information processing were abnormal, and some were related to clinical characteristics. fALFF in the left postcentral or right precentral gyrus may be used as a biomarker of narcolepsy, whereas fALFF in the right fusiform and the FC strength of the left temporal pole middle temporal gyrus with the putamen may be clinical indicators to assess the drowsiness severity of narcolepsy.

Keywords: narcolepsy; functional magnetic resonance; fractional low-frequency amplitude of low-frequency fluctuation; connectivity; drowsiness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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