Larger hypothalamic volume in narcolepsy type 1

Abstract Study Objectives Narcolepsy type 1 (NT1) is a neurological sleep disorder. Postmortem studies have shown 75%–90% loss of the 50 000–70 000 hypocretin-producing neurons and 64%–94% increase in the 64 000–120 000 histaminergic neurons and conflicting indications of gliosis in the hypothalamus...

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Published in:Sleep (New York, N.Y.) N.Y.), 2023-11, Vol.46 (11), p.1
Main Authors: Juvodden, Hilde T, Alnæs, Dag, Lund, Martina J, Agartz, Ingrid, Andreassen, OIe A, Server, Andres, Thorsby, Per M, Westlye, Lars T, Knudsen Heier, Stine
Format: Article
Language:English
Subjects:
Adolescent
Adult
Analysis
Brain
Child
Female
Gliosis
Humans
Hypothalamus
Hypothalamus - diagnostic imaging
Influenza A Virus, H1N1 Subtype
Medical research
Medicine, Experimental
Narcolepsy
Neurological Disorders
Neurons
Orexins
Sleep
Sleep disorders
Type 2 diabetes
Young Adult
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Summary:Abstract Study Objectives Narcolepsy type 1 (NT1) is a neurological sleep disorder. Postmortem studies have shown 75%–90% loss of the 50 000–70 000 hypocretin-producing neurons and 64%–94% increase in the 64 000–120 000 histaminergic neurons and conflicting indications of gliosis in the hypothalamus of NT1 patients. The aim of this study was to compare MRI-based volumes of the hypothalamus in patients with NT1 and controls in vivo. Methods We used a segmentation tool based on deep learning included in Freesurfer and computed the volume of the whole hypothalamus, left/right part of the hypothalamus, and 10 hypothalamic subregions. We included 54 patients with post-H1N1 NT1 (39 females, mean age 21.8 ± 11.0 years) and 114 controls (77 females, mean age 23.2 ± 9.0 years). Group differences were tested with general linear models using permutation testing in Permutation Analysis of Linear Models and evaluated after 10 000 permutations, yielding two-tailed P-values. Furthermore, a stepwise Bonferroni correction was performed after dividing hypothalamus into smaller regions. Results The analysis revealed larger volume for patients compared to controls for the whole hypothalamus (Cohen’s d = 0.71, p = 0.0028) and for the left (d = 0.70, p = 0.0037) and right part of the hypothalamus (d = 0.65, p = 0.0075) and left (d = 0.72, p = 0.0036) and right tubular-inferior (d = 0.71, p = 0.0037) hypothalamic subregions. Conclusions In conclusion, patients with post-H1N1 NT1 showed significantly larger hypothalamic volume than controls, in particular in the tubular-inferior subregions which could reflect several processes as previous studies have indicated neuroinflammation, gliosis, and changes in the numbers of different cell types. Graphical Abstract
ISSN:0161-8105
1550-9109
DOI:10.1093/sleep/zsad173