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. 2021 Mar 11:12:634660.
doi: 10.3389/fneur.2021.634660. eCollection 2021.

Compromised Dynamic Cerebral Autoregulation in Patients With Central Disorders of Hypersomnolence

Fang Deng  1 , Yanan Zhang  1 , Ran Zhang  1 , Qi Tang  1 , Zhenni Guo  2 , Yudan Lv  1 , Zan Wang  1 , Yi Yang  2
Affiliations

Compromised Dynamic Cerebral Autoregulation in Patients With Central Disorders of Hypersomnolence

Fang Deng et al. Front Neurol. .

Abstract

Objective: We aimed to investigate the dynamic cerebral autoregulation (dCA) in patients with central disorders of hypersomnolence during wakefulness. Methods: Thirty-six patients with central disorders of hypersomnolence were divided into three groups according to polysomnography and multiple sleep latency test results: the idiopathic hypersomnia group (IH), narcolepsy type 1 without rapid-eye-movement sleep behavior disorder group (NT1-RBD), and narcolepsy type 1 with rapid-eye-movement sleep behavior disorder group (NT1 + RBD), with 12 patients in each group. Twelve sex- and age-matched healthy controls were recruited. We assessed the Epworth sleepiness scale (ESS) and dCA of all subjects. dCA was assessed by analyzing the phase difference (PD) using transfer function analysis. The ESS and dCA were analyzed before and after standardized treatment in 24 patients with narcolepsy type 1. Results: The overall PD of the IH, NT1-RBD, and NT1 + RBD groups were lower than that of the control group (P < 0.001). There were no significant differences between the overall PD of the NT1-RBD and NT1 + RBD group (P > 0.05). The ESS scores decreased and the overall PD increased after treatment in 24 patients with narcolepsy type 1 (P < 0.001). Multivariable analysis showed that mean sleep latency in multiple sleep latency test was independently associated with impaired overall PD (P < 0.05). Conclusions: The dCA is impaired in patients with central disorders of hypersomnolence. The impairment of dCA occurs irrespective of NT1-RBD/+RBD. The ESS score and dCA improved in patients with narcolepsy type 1 after medication treatment. The mean sleep latency in multiple sleep latency test was independently associated with impaired dCA. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02752139.

Keywords: central disorders of hypersomnolence; dynamic cerebral autoregulation; idiopathic hypersomnia; narcolepsy type 1; rapid-eye-movement sleep behavior disorder.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
ESS scores in the patients with IH, NT1-RBD, NT1 + RBD, and controls. *Different from controls (P < 0.05). ESS, Epworth sleepiness scale.
Figure 2
Figure 2
The autoregulatory parameter and statistical distributions in the patients with IH, NT1-RBD, NT1 + RBD, and controls. Statistical distributions of overall phase difference (A) and its transfer function (B) in each group. *Difference of overall phase difference in patients with IH, NT1-RBD, NT1 + RBD, and controls (P < 0.05).
Figure 3
Figure 3
Comparison of ESS in narcolepsy type 1 group before and after treatment. *Represents statistical difference (P < 0.05).
Figure 4
Figure 4
The autoregulatory parameter and statistical distributions in narcolepsy type 1 group before and after treatment. Statistical distributions of phase difference (A) and its transfer function (B) in narcolepsy type 1 group before and after treatment. *Represents statistical difference (P < 0.05).
See this image and copyright information in PMC

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