TY - JOUR
T1 - Clinical, polysomnographic and genome-wide association analyses of narcolepsy with cataplexy
T2 - a European Narcolepsy Network study
AU - Luca, Gianina
AU - Haba-Rubio, José
AU - Dauvilliers, Yves
AU - Lammers, Gert-Jan
AU - Overeem, Sebastiaan
AU - Donjacour, Claire E
AU - Mayer, Geert
AU - Javidi, Sirous
AU - Iranzo, Alex
AU - Santamaria, Joan
AU - Peraita-Adrados, Rosa
AU - Hor, Hyun
AU - Kutalik, Zoltan
AU - Plazzi, Giuseppe
AU - Poli, Francesca
AU - Pizza, Fabio
AU - Arnulf, Isabelle
AU - Lecendreux, Michel
AU - Bassetti, Claudio
AU - Mathis, Johannes
AU - Heinzer, Raphael
AU - Jennum, Poul
AU - Knudsen, Stine
AU - Geisler, Peter
AU - Wierzbicka, Aleksandra
AU - Feketeova, Eva
AU - Pfister, Corinne
AU - Khatami, Ramin
AU - Baumann, Christian
AU - Tafti, Mehdi
AU - Network, European Narcolepsy
PY - 2013/10
Y1 - 2013/10
N2 - The aim of this study was to describe the clinical and PSG characteristics of narcolepsy with cataplexy and their genetic predisposition by using the retrospective patient database of the European Narcolepsy Network (EU-NN). We have analysed retrospective data of 1099 patients with narcolepsy diagnosed according to International Classification of Sleep Disorders-2. Demographic and clinical characteristics, polysomnography and multiple sleep latency test data, hypocretin-1 levels, and genome-wide genotypes were available. We found a significantly lower age at sleepiness onset (men versus women: 23.74 ± 12.43 versus 21.49 ± 11.83, P = 0.003) and longer diagnostic delay in women (men versus women: 13.82 ± 13.79 versus 15.62 ± 14.94, P = 0.044). The mean diagnostic delay was 14.63 ± 14.31 years, and longer delay was associated with higher body mass index. The best predictors of short diagnostic delay were young age at diagnosis, cataplexy as the first symptom and higher frequency of cataplexy attacks. The mean multiple sleep latency negatively correlated with Epworth Sleepiness Scale (ESS) and with the number of sleep-onset rapid eye movement periods (SOREMPs), but none of the polysomnographic variables was associated with subjective or objective measures of sleepiness. Variant rs2859998 in UBXN2B gene showed a strong association (P = 1.28E-07) with the age at onset of excessive daytime sleepiness, and rs12425451 near the transcription factor TEAD4 (P = 1.97E-07) with the age at onset of cataplexy. Altogether, our results indicate that the diagnostic delay remains extremely long, age and gender substantially affect symptoms, and that a genetic predisposition affects the age at onset of symptoms.
AB - The aim of this study was to describe the clinical and PSG characteristics of narcolepsy with cataplexy and their genetic predisposition by using the retrospective patient database of the European Narcolepsy Network (EU-NN). We have analysed retrospective data of 1099 patients with narcolepsy diagnosed according to International Classification of Sleep Disorders-2. Demographic and clinical characteristics, polysomnography and multiple sleep latency test data, hypocretin-1 levels, and genome-wide genotypes were available. We found a significantly lower age at sleepiness onset (men versus women: 23.74 ± 12.43 versus 21.49 ± 11.83, P = 0.003) and longer diagnostic delay in women (men versus women: 13.82 ± 13.79 versus 15.62 ± 14.94, P = 0.044). The mean diagnostic delay was 14.63 ± 14.31 years, and longer delay was associated with higher body mass index. The best predictors of short diagnostic delay were young age at diagnosis, cataplexy as the first symptom and higher frequency of cataplexy attacks. The mean multiple sleep latency negatively correlated with Epworth Sleepiness Scale (ESS) and with the number of sleep-onset rapid eye movement periods (SOREMPs), but none of the polysomnographic variables was associated with subjective or objective measures of sleepiness. Variant rs2859998 in UBXN2B gene showed a strong association (P = 1.28E-07) with the age at onset of excessive daytime sleepiness, and rs12425451 near the transcription factor TEAD4 (P = 1.97E-07) with the age at onset of cataplexy. Altogether, our results indicate that the diagnostic delay remains extremely long, age and gender substantially affect symptoms, and that a genetic predisposition affects the age at onset of symptoms.
U2 - 10.1111/jsr.12044
DO - 10.1111/jsr.12044
M3 - Journal article
C2 - 23496005
SN - 1365-2869
VL - 22
SP - 482
EP - 495
JO - Journal of Sleep Research
JF - Journal of Sleep Research
IS - 5
ER -