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Abnormální mikrostruktura spánku a autonomní odpověď u narkolepsie


Authors: J. Vaňková;  P. Bušek;  J. Volná;  K. Šonka;  S. Nevšímalová
Authors‘ workplace: Neurologická klinika 1. LF MU a VFN Praha
Published in: Cesk Slov Neurol N 2007; 70/103(2): 158-162
Category: Original Paper

Overview

Patofyziologickým podkladem narkolepsie-kataplexie je ztráta hypokretinových neuronů posterolaterálního hypotalamu. Předpokládaným projevem tohoto deficitu je změna mikrostruktury a autonomních funkcí ve spánku u těchto pacientů. Cílem studie bylo hodnocení mikrostruktury NREM (non-rapid eye movement) spánku metodou sledování cyklických alternujících vzorců (CAP) a změny variability srdeční frekvence (HRV). Do studie bylo zahrnuto 15 pacientů s narkolepsií-kataplexií (průměrný věk 35 ± 8,5; věkové rozmezí 22-44 let) a 15 zdravých kontrol (31 ± 11,4;19-48 let). Obě skupiny podstoupily 2 následná polysomnografická vyšetření, pro analýzu CAP a HRV byla zpracována data ze 2. noci. Prokázali jsme signifikantní snížení CAP, provázené snížením LF a zvýšením HF složky při redukci poměru LF/HF v průběhu NREM spánku. Výsledky vyjadřují poruchu kolísání prahu probuzení u narkolepsie-kataplexie, která je provázena redukcí tonu sympatiku během NREM spánku. Domníváme se, narkolepsie nevzniká pouze v důsledku poruchy regulace REM spánku, nýbrž že je současně vlivem deficientní hypokretinové modulace porušena i regulace NREM spánku.

Klíčová slova:
narkolepsie – hypokretin – cyklický alternující vzorek – variabilita srdeční frekvence


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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2007 Issue 2

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