Sympathetic and cardiovascular activity during cataplexy in narcolepsy

Vincenzo Donadio, Giuseppe Plazzi, Stefano Vandi, Christian Franceschini, Tomas Karlsson, Pasquale Montagna, Roberto Vetrugno, Enrico Bugiardini, Emmanuel Mignot, Rocco Liguori

Research output: Contribution to journalArticlepeer-review


Autonomic nervous system activity changes have been described during cataplexy as playing a role in triggering it. To confirm these previous findings, we investigated the time course of sympathetic and cardiovascular activities during cataplexy. We made for the first time microneurographic recordings of 10 cataplectic episodes in three patients with hypocretin-deficient narcolepsy. During microneurography, muscle sympathetic nerve activity (MSNA) was recorded simultaneously with heart rate (HR), respiratory movements, arterial finger blood pressure (BP), electroencephalography, electro-oculogram and superficial electromyogram. Results showed no significant autonomic changes before the onset of the cataplectic episodes. Cataplexy was associated with a significant increase in MSNA and BP compared with baseline, whereas HR was markedly decreased. An irregular breathing pattern mainly characterized by apnea typically occurred during the attacks. In conclusion, our findings did not show significant changes in autonomic activity prior to cataplexy onset, ruling out a triggering role of the autonomic system. However, cataplexy was associated with co-activation of sympathetic and parasympathetic autonomic systems, a pattern reminiscent of that reported during the vigilance reaction in animals.

Original languageEnglish
Pages (from-to)458-463
Number of pages6
JournalJournal of Sleep Research
Issue number4
Publication statusPublished - Dec 2008


  • Blood pressure
  • Cataplexy
  • Heart rate
  • Muscle sympathetic nerve activity
  • Narcolepsy
  • Vigilance reaction

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Cognitive Neuroscience
  • Medicine(all)


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