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. 2024 Jul;11(4):e200263.
doi: 10.1212/NXI.0000000000200263. Epub 2024 Jun 17.

PET Study of Microglial Activation in Kleine-Levin Syndrome

Lucie Barateau  1 , Anis Krache  1 , Alexandre Da Costa  1 , Michel Lecendreux  1 , Sofiene Chenini  1 , Nicolas Arlicot  1 , Patrick Vourc'h  1 , Mathieu Alonso  1 , Anne-Sophie Salabert  1 , Séverine Beziat  1 , Isabelle Jaussent  1 , Denis Mariano-Goulart  1 , Pierre Payoux  1 , Yves Dauvilliers  1
Affiliations

PET Study of Microglial Activation in Kleine-Levin Syndrome

Lucie Barateau et al. Neurol Neuroimmunol Neuroinflamm. 2024 Jul.

Abstract

Objectives: Kleine-Levin syndrome (KLS) is a rare recurrent hypersomnolence disorder associated with cognitive and behavioral disturbances, of unknown origin, but inflammatory mechanisms could be involved. We aimed to explore in vivo microglia activation using [18F]DPA-714 PET imaging in patients with KLS compared with controls, and during symptomatic vs asymptomatic periods.

Methods: Patients with KLS and controls underwent a standardized clinical evaluation and PET imaging, using a radiolabeled ligand specific to the 18 kDa translocator protein. Images were processed on the PMOD (peripheral module) interface using a standard uptake value (SUV). Five regions of interest (ROIs) were analyzed: hypothalamus, thalamus, frontal area, cerebellum, and whole brain. SUV ratios (SUVr) were calculated by normalizing SUV with cerebellum uptake.

Results: Images of 17 consecutive patients with KLS (7 during episodes, 10 out of episodes) and 14 controls were analyzed. We found no SUV/SUVr difference between KLS and controls, between patients in and out episodes in all ROIs, and no correlation between SUVr and episode duration at the time of PET scan. No association was found between SUVr and sex, disease duration, or orexin levels.

Discussion: Our findings do not support the presence of neuroinflammation in KLS. Further research is needed to identify relevant biomarkers in KLS.

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Conflict of interest statement

L. Barateau received funds for traveling to conferences by Idorsia and Bioprojet, and board engagements by Jazz, Takeda, Idorsia, and Bioprojet; M. Lecendreux reports serving as a consultant and participating in advisory boards for NLS Pharma, Jazz Pharmaceuticals, Biocodex, and Bioprojet; P. Payoux received funds for seminars, board engagements and travel to conferences by EISAI, General Electric Healthcare, and Siemens; A Krache was performing his PhD with Zionexa—General Electric Healthcare; Y. Dauvilliers received funds for seminars, board engagements, and travel to conferences by UCB Pharma, Jazz, Idorsia, Takeda, Avadel, and Bioprojet; S. Chenini, S. Béziat, A. Da Costa, I. Jaussent, A.S. Salabert, M. Alonso, S. Stein, and D. Mariano-Goulart report no disclosures relevant to the manuscript. Go to Neurology.org/NN for full disclosures.

Figures

Figure
Figure. Box Plot Representation of Global and Regional [18F]DPA-714 Standard Uptake Value Ratio (SUVr) Data
(A) In the group of patients with KLS during a symptomatic episode (in) (n = 7) vs controls (n = 14). (B) In the group of patients with KLS, according to the condition: during a symptomatic episode (in) and during an asymptomatic period (out). KLS = Kleine-Levin syndrome; SUV = standard uptake value; SUVr = SUV ratio.
See this image and copyright information in PMC

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