Maria Engström1, Thomas Karlsson2, Anne-Marie Landtblom3. 1. Department of Medical and Health Sciences (IMH), Division of Radiology, Linköping University, Linköping, Sweden ; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden. 2. Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden ; Department of Behavioral Science and Learning, Division of Disability Research and Linnaeus Centre HEAD, Linköping University, Linköping, Sweden. 3. Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden ; Department of Clinical and Experimental Medicine (IKE), Division of Neurology, Linköping University, UHL, LiM, Linköping, Sweden.
Abstract
STUDY OBJECTIVES: The objective of this study was to investigate if combined measures of activation in the thalamus and working memory capacity could guide the diagnosis of Kleine-Levin Syndrome (KLS). A second objective was to obtain more insight into the neurobiological causes of KLS. DESIGN: Matched group and consecutive recruitment. SETTING: University hospital neurology department and imaging center. PATIENTS OR PARTICIPANTS: Eighteen patients with KLS diagnosed according to the International Classification of Sleep Disorders and 26 healthy controls were included. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Working memory capacity was assessed by the listening span task. A version of this task (reading span) was presented to the participants during functional magnetic resonance imaging (fMRI). Activation in the thalamus was measured in a region of interest analysis. A combination of the working memory capacity and the thalamic activation measures resulted in 80% prediction accuracy, 81% sensitivity, and 78% specificity regarding the ability to separate KLS patients from healthy controls. The controls had an inverse relation between working memory capacity and thalamic activation; higher performing participants had lower thalamic activation (r = -0.41). KLS patients showed the opposite relationship; higher performing participants had a tendency to higher thalamic activation (r = -0.35). CONCLUSIONS: This study shows that functional neuroimaging of the thalamus combined with neuropsychological assessment of working memory function provides a means to guide diagnosis of Kleine-Levin Syndrome. Results in this study also indicate that imaging of brain function and evaluation of cognitive capacity can give insights into the neurobiological mechanisms of Kleine-Levin Syndrome.
STUDY OBJECTIVES: The objective of this study was to investigate if combined measures of activation in the thalamus and working memory capacity could guide the diagnosis of Kleine-Levin Syndrome (KLS). A second objective was to obtain more insight into the neurobiological causes of KLS. DESIGN: Matched group and consecutive recruitment. SETTING: University hospital neurology department and imaging center. PATIENTS OR PARTICIPANTS: Eighteen patients with KLS diagnosed according to the International Classification of Sleep Disorders and 26 healthy controls were included. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Working memory capacity was assessed by the listening span task. A version of this task (reading span) was presented to the participants during functional magnetic resonance imaging (fMRI). Activation in the thalamus was measured in a region of interest analysis. A combination of the working memory capacity and the thalamic activation measures resulted in 80% prediction accuracy, 81% sensitivity, and 78% specificity regarding the ability to separate KLS patients from healthy controls. The controls had an inverse relation between working memory capacity and thalamic activation; higher performing participants had lower thalamic activation (r = -0.41). KLS patients showed the opposite relationship; higher performing participants had a tendency to higher thalamic activation (r = -0.35). CONCLUSIONS: This study shows that functional neuroimaging of the thalamus combined with neuropsychological assessment of working memory function provides a means to guide diagnosis of Kleine-Levin Syndrome. Results in this study also indicate that imaging of brain function and evaluation of cognitive capacity can give insights into the neurobiological mechanisms of Kleine-Levin Syndrome.
Entities:
Keywords:
Functional magnetic resonance imaging (fMRI); hypersomnia; narcolepsy; thalamus; working memory
Authors: D E Fleck; J C Eliassen; M Durling; M Lamy; C M Adler; M P DelBello; P K Shear; M A Cerullo; J-H Lee; S M Strakowski Journal: Mol Psychiatry Date: 2010-10-26 Impact factor: 15.992
Authors: Jing Yu Wang; Fang Han; Song X Dong; Jing Li; Pei An; Xiao Zhe Zhang; Yuan Chang; Long Zhao; Xue Li Zhang; Ya Nan Liu; Han Yan; Qing Hua Li; Yan Hu; Chang Jun Lv; Zhan Cheng Gao; Kingman P Strohl Journal: Sleep Date: 2016-04-01 Impact factor: 5.849