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Review
. 2018 Jul 21;18(9):58.
doi: 10.1007/s11910-018-0866-y.

Neuroimaging in the Kleine-Levin Syndrome

Maria Engström  1   2   3 , Francesco Latini  4 , Anne-Marie Landtblom  5   6
Affiliations
Review

Neuroimaging in the Kleine-Levin Syndrome

Maria Engström et al. Curr Neurol Neurosci Rep. .

Abstract

Purpose of review: The purpose was to review the most recent literature on neuroimaging in the Kleine-Levin syndrome (KLS). We aimed to investigate if frontotemporal and thalamic dysfunction are key KLS signatures, and if recent research indicates other brain networks of interest that elucidate KLS symptomatology and aetiology.

Recent findings: In a comprehensive literature search, we found 12 original articles published 2013-2018. Most studies report deviations related to cerebral perfusion, glucose metabolism, or blood-oxygen-level-dependent responses in frontotemporal areas and/or the thalamus. Studies also report dysfunction in the temporoparietal junction and the oculomotor network that also were related to clinical parameters. We discuss these findings based on recent research on thalamocortical networks and brain stem white matter tracts. The hypothesis of frontotemporal and thalamic involvement in KLS was confirmed, and additional findings in the temporoparietal junction and the oculomotor system suggest a broader network involvement, which can be investigated by future high-resolution and multimodal imaging.

Keywords: Diffusion weighted imaging (DWI); Functional magnetic resonance imaging (fMRI); Kleine-Levin syndrome (KLS); Magnetic resonance spectroscopy (MRS); Positron emission tomography (PET); Single photon emission computed tomography (SPECT).

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Conflict of interest statement

Conflict of Interest

Maria Engström, Francesco Latini, and Anne-Marie Landtblom each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Schematic overview of suggested brain regions and networks involved in KLS according to recent neuroimaging reviews. a Frontotemporal regions with observed hypoperfusion and glucose hypermetabolism in KLS. b Thalamocortical networks with reported dysfunction in SPECT, PET, and fMRI studies. c The temporoparietal junction where cerebral perfusion is related to experiences of depersonalization and derealization in KLS. d Oculomotor and sleep-wake networks. Functional connectivity and perfusion studies show deviant function in the oculomotor network (blue) that involves nuclei in the brain stem reticular formation (purple) partially overlapping with the sleep-wake network (red)
See this image and copyright information in PMC

References

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    1. Engström M, Vigren P, Karlsson T, Landtblom AM. Working memory in 8 Kleine-Levin syndrome patients: an fMRI study. Sleep. 2009;32:681–688. doi: 10.1093/sleep/32.5.681. - DOI - PMC - PubMed
    1. Engström M. Neuroimaging in Kleine-Levin syndrome. In: Thorpy M, Nofzinger E, Maquet P, editors. Neuroimaging of sleep and sleep disorders: Cambridge University Press; 2013.

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