Lower wake resting sympathetic and cardiovascular activities in narcolepsy with cataplexy

Vincenzo Donadio, Rocco Liguori, Stefano Vandi, Fabio Pizza, Yves Dauvilliers, Valentina Leta, Maria Pia Giannoccaro, Agostino Baruzzi, Giuseppe Plazzi

Research output: Contribution to journalArticle

Abstract

Objective: Conflicting data have been reported on resting autonomic tone in narcolepsy with cataplexy (NC), including reduced or increased sympathetic activity; to settle this important point, we aimed to measure the resting sympathetic and cardiovascular activities in patients with NC by direct microneurographic monitoring of muscle sympathetic nerve activity (MSNA) during wakefulness. Methods: We studied 19 untreated patients with established criteria for NC and hypocretin deficiency and 19 sex- and age-matched healthy subjects. Subjects underwent resting microneurographic recording of MSNA from peroneal nerve and heart rate (HR), whereas blood pressure (BP) was measured with a sphygmomanometer after the end of microneurographic recording. The awake state was continuously monitored by an ambulatory polygraphic recorder. Results: Patients with NC displayed lower resting MSNA, HR, and BP values than controls. Pearson regression analysis showed a correlation between CSF hypocretin-1 level and MSNA or HR, whereas no correlation was found with BP; however, patients with virtually absent hypocretin-1 displayed lower BP than patients with the highest hypocretin-1 value. Conclusions: (1) Patients with NC displayed decreased restingMSNA, HR, and BP during wakefulness, lowering their cardiovascular risk profile; (2) CSF hypocretin-1 deficiency was correlated withMSNA or HR, supporting a direct effect of hypocretin on autonomic regulation; (3) although hypocretin-1 was not correlated with BP, patients with absent hypocretin-1 had lower BP.

Original languageEnglish
Pages (from-to)1080-1086
Number of pages7
JournalNeurology
Volume83
Issue number12
Publication statusPublished - Sep 1 2014

ASJC Scopus subject areas

  • Clinical Neurology
  • Medicine(all)

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