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Sleep. 2017 Oct 1;40(10). doi: 10.1093/sleep/zsx140.

Altered Regional Cerebral Blood Flow in Idiopathic Hypersomnia.

Author information

1
Center for Studies in Behavioral Neurobiology and Department of Exercise Science, Concordia University, Montreal, Quebec, Canada.
2
PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
3
Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada.
4
Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.
5
Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada.
6
Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.
7
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
8
Department of Neurosciences, Université de Montréal, Montreal, Quebec, Canada.

Abstract

Study Objectives:

Idiopathic hypersomnia is characterized by excessive daytime sleepiness, despite normal or long sleep time. Its pathophysiological mechanisms remain unclear. This pilot study aims at characterizing the neural correlates of idiopathic hypersomnia using single photon emission computed tomography.

Methods:

Thirteen participants with idiopathic hypersomnia and 16 healthy controls were scanned during resting wakefulness using a high-resolution single photon emission computed tomography scanner with 99mTc-ethyl cysteinate dimer to assess cerebral blood flow. The main analysis compared regional cerebral blood flow distribution between the two groups. Exploratory correlations between regional cerebral blood flow and clinical characteristics evaluated the functional correlates of those brain perfusion patterns. Significance was set at p < .05 after correction for multiple comparisons.

Results:

Participants with idiopathic hypersomnia showed regional cerebral blood flow decreases in medial prefrontal cortex and posterior cingulate cortex and putamen, as well as increases in amygdala and temporo-occipital cortices. Lower regional cerebral blood flow in the medial prefrontal cortex was associated with higher daytime sleepiness.

Conclusions:

These preliminary findings suggest that idiopathic hypersomnia is characterized by functional alterations in brain areas involved in the modulation of vigilance states, which may contribute to the daytime symptoms of this condition. The distribution of regional cerebral blood flow changes was reminiscent of the patterns associated with normal non-rapid-eye-movement sleep, suggesting the possible presence of incomplete sleep-wake transitions. These abnormalities were strikingly distinct from those induced by acute sleep deprivation, suggesting that the patterns seen here might reflect a trait associated with idiopathic hypersomnia rather than a non-specific state of sleepiness.

KEYWORDS:

idiopathic hypersomnia; single photon emission computed tomography; sleep disorders; sleepiness

PMID:
28958044
DOI:
10.1093/sleep/zsx140
[Indexed for MEDLINE]

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