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Baiardi S, Pizza F, Polischi B, Moresco M, Abu-Rumeileh S, Plazzi G, Parchi P. Cerebrospinal fluid biomarkers of neurodegeneration in narcolepsy type 1. Sleep 2021; 43:5573415. [PMID: 31552425 DOI: 10.1093/sleep/zsz215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/27/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To measure the levels of five neurodegenerative biomarkers in the cerebrospinal fluid (CSF) of patients with narcolepsy type 1 (NT1) with variable disease duration. METHODS Following a standardized protocol of CSF collection and storage, we measured CSF total- and phosphorylated-tau, amyloid-beta 1-40 and 1-42, and neurofilament light chain (NfL) proteins in 30 nonneurological controls and 36 subjects with NT1, including 14 patients with recent disease onset (i.e. ≤12 months, short disease duration group). RESULTS CSF levels of all biomarkers were similar in NT1 subjects and controls. The comparison between NT1 with short and long disease duration only revealed slightly higher levels of CSF amyloid-beta 1-40 in the former group (median 9,549.5, interquartile range [IQR] 7,064.2-11,525.0 vs. 6,870.0, IQR 5,133.7-9,951.2, p = 0.043). CSF storage time did not influence the levels of the tested biomarkers. CONCLUSIONS The measurement of CSF total-tau, phosphorylated-tau, amyloid-beta 1-40 and 1-42, and NfL proteins is not informative in NT1.
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Affiliation(s)
- Simone Baiardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Barbara Polischi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Monica Moresco
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Samir Abu-Rumeileh
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Piero Parchi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
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2
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Berteotti C, Liguori C, Pace M. Dysregulation of the orexin/hypocretin system is not limited to narcolepsy but has far-reaching implications for neurological disorders. Eur J Neurosci 2020; 53:1136-1154. [PMID: 33290595 DOI: 10.1111/ejn.15077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
Neuropeptides orexin A and B (OX-A/B, also called hypocretin 1 and 2) are released selectively by a population of neurons which projects widely into the entire central nervous system but is localized in a restricted area of the tuberal region of the hypothalamus, caudal to the paraventricular nucleus. The OX system prominently targets brain structures involved in the regulation of wake-sleep state switching, and also orchestrates multiple physiological functions. The degeneration and dysregulation of the OX system promotes narcoleptic phenotypes both in humans and animals. Hence, this review begins with the already proven involvement of OX in narcolepsy, but it mainly discusses the new pre-clinical and clinical insights of the role of OX in three major neurological disorders characterized by sleep impairment which have been recently associated with OX dysfunction, such as Alzheimer's disease, stroke and Prader Willi syndrome, and have been emerged over the past 10 years to be strongly associated with the OX dysfunction and should be more considered in the future. In the light of the impairment of the OX system in these neurological disorders, it is conceivable to speculate that the integrity of the OX system is necessary for a healthy functioning body.
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Affiliation(s)
- Chiara Berteotti
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Pace
- Genetics and Epigenetics of Behaviour Laboratory, Istituto Italiano di Tecnologia, Genova, Italy
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Romigi A, Bari M, Liguori C, Izzi F, Rapino C, Nuccetelli M, Battista N, Bernardini S, Centonze D, Mercuri NB, Placidi F, Maccarrone M. CSF Levels of the Endocannabinoid Anandamide are Reduced in Patients with Untreated Narcolepsy Type 1: A Pilot Study. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2020; 19:142-147. [PMID: 32148204 DOI: 10.2174/1871527319666200309115602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Endocannabinoids (ECs) modulate both excitatory and inhibitory components in the CNS. There is a growing body of evidence that shows ECs influence both hypothalamic orexinergic and histaminergic neurons involved in narcolepsy physiopathology. Therefore, ECs may influence sleep and sleep-wake cycle. OBJECTIVE To evaluate EC levels in the CSF of untreated narcoleptic patients to test whether ECs are dysregulated in Narcolepsy Type 1 (NT1) and Type 2 (NT2). METHODS We compared CSF Anandamide (AEA), 2-Arachidonoylglycerol (2-AG) and orexin in narcoleptic drug-naïve patients and in a sample of healthy subjects. RESULTS We compared NT1 (n=6), NT2 (n=6), and healthy controls (n=6). We found significantly reduced AEA levels in NT1 patients compared to both NT2 and controls. No differences were found between AEA levels in NT2 versus controls and between 2-AG levels in all groups, although a trend toward a decrease in NT1 was evident. Finally, the CSF AEA level was related to CSF orexin levels in all subjects. CONCLUSION We demonstrated that the EC system is dysregulated in NT1.
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Affiliation(s)
- Andrea Romigi
- IRCCS Neuromed Sleep Medicine Center, Via Atinense, 18 Pozzilli (IS), Italy
| | - Monica Bari
- Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Francesca Izzi
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Cinzia Rapino
- Faculty of Bioscience and Technology for Food, University of Teramo, Agriculture and Environment, Teramo, Italy
| | - Marzia Nuccetelli
- Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Natalia Battista
- Faculty of Bioscience and Technology for Food, University of Teramo, Agriculture and Environment, Teramo, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Diego Centonze
- IRCCS Neuromed Sleep Medicine Center, Via Atinense, 18 Pozzilli (IS), Italy
| | | | - Fabio Placidi
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Mauro Maccarrone
- Campus Bio-Medico University of Rome, Italy.,European Center for Brain Research, IRCCS Santa Lucia Foundation, Rome, Italy
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4
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Gabelle A, Jaussent I, Bouallègue FB, Lehmann S, Lopez R, Barateau L, Grasselli C, Pesenti C, de Verbizier D, Béziat S, Mariano-Goulart D, Carlander B, Dauvilliers Y. Reduced brain amyloid burden in elderly patients with narcolepsy type 1. Ann Neurol 2018; 85:74-83. [PMID: 30387527 DOI: 10.1002/ana.25373] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine whether brain amyloid burden in elderly patients with narcolepsy type 1 (NT1) is lower than in controls, and to assess in patients with NT1 the relationships between amyloid burden, cerebral spinal fluid (CSF) markers of Alzheimer disease (AD), CSF orexin-A, and cognitive profile. METHODS Cognitive and 18 F-florbetapir positron emission tomography (PET) data were compared in patients with NT1 aged ≥ 65 years (n = 23) and in age- and sex-matched controls free of clinical dementia selected from the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 69) and the Multi-Domain Intervention Alzheimer's Prevention Trial (MAPT-18F AV45-PET; n = 23) cohorts. The standardized uptake values (SUVs) of the cortical retention index for 6 regions of interest were computed and averaged to create a mean SUV ratio normalized to 3 subcortical reference regions (cerebellum, pons, and a composite region). A cortical/cerebellum SUV ratio ≥ 1.17 defined positive PET amyloid. RESULTS Lower cortical amyloid burden was observed in the NT1 than in the ADNI and MAPT-AV45 groups (mean cortical/cerebellum SUV ratios = 0.95 ± 0.15, 1.11 ± 0.18 [p < 0.0001], and 1.14 ± 0.17 [p = 0.0005], respectively). Similar results were obtained with all subcortical reference regions and for all cortical regions of interest, except cingulum. Only 1 patient with NT1 (4.4%) had positive PET amyloid compared with 27.5% in the ADNI and 30.4% in the MAPT-AV45 group. In the NT1 group, cortical or regional amyloid load was not associated with CSF orexin-A, CSF AD biomarkers, or neuropsychological profile. INTERPRETATION Lower brain amyloid burden, assessed by 18 F-florbetapir PET, in patients with NT1 suggests delayed appearance of amyloid plaques. ANN NEUROL 2019;85:74-83.
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Affiliation(s)
- Audrey Gabelle
- Memory Research and Resources Center, Department of Neurology, Gui de Chauliac University Hospital Center.,University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research
| | - Isabelle Jaussent
- University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research
| | - Fayçal Ben Bouallègue
- University of Montpellier.,Department of Nuclear Medicine, Montpellier University Hospital.,PhyMedExp, National Institute of Health and Medical Research, National Center for Scientific Research
| | - Sylvain Lehmann
- University of Montpellier.,National Institute of Health and Medical Research U1183, Saint Eloi Hospital
| | - Régis Lopez
- University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research.,Narcolepsy National Reference Center, Sleep Center, Department of Neurology, Montpellier University Hospital Center, Montpellier, France
| | - Lucie Barateau
- University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research.,Narcolepsy National Reference Center, Sleep Center, Department of Neurology, Montpellier University Hospital Center, Montpellier, France
| | - Caroline Grasselli
- Memory Research and Resources Center, Department of Neurology, Gui de Chauliac University Hospital Center
| | - Carole Pesenti
- Narcolepsy National Reference Center, Sleep Center, Department of Neurology, Montpellier University Hospital Center, Montpellier, France
| | | | - Séverine Béziat
- University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research
| | - Denis Mariano-Goulart
- University of Montpellier.,Department of Nuclear Medicine, Montpellier University Hospital.,PhyMedExp, National Institute of Health and Medical Research, National Center for Scientific Research
| | - Bertrand Carlander
- Narcolepsy National Reference Center, Sleep Center, Department of Neurology, Montpellier University Hospital Center, Montpellier, France
| | - Yves Dauvilliers
- University of Montpellier.,National Institute of Health and Medical Research U1061, Neuropsychiatry: Epidemiological and Clinical Research.,Narcolepsy National Reference Center, Sleep Center, Department of Neurology, Montpellier University Hospital Center, Montpellier, France
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Liguori C, Placidi F, Izzi F, Nuccetelli M, Bernardini S, Sarpa MG, Cum F, Marciani MG, Mercuri NB, Romigi A. Beta-amyloid and phosphorylated tau metabolism changes in narcolepsy over time. Sleep Breath 2016; 20:277-83; discussion 283. [PMID: 26803606 DOI: 10.1007/s11325-015-1305-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 11/26/2015] [Accepted: 12/23/2015] [Indexed: 02/01/2023]
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Heier M, Gautvik K. What happens in the brain in narcolepsy over time? Sleep Med 2014; 15:1427. [DOI: 10.1016/j.sleep.2014.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/02/2014] [Indexed: 11/29/2022]
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