Avaliação e relação da função executiva com a polissonografia na Narcolepsia tipo 1 ; Type 1 Narcolepsy Executive Function Assessment and Polysomnographic Correlation

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina ; Introduction: Sleep is an important factor to both well-being and cognition. In type 1 narcolepsy (NT1) there is a deficit of orexin which negatively impact the transitions of the sleep-wake cycle. Notably, NT1 demonstrates hypoactivity in several neuronal circuits especially in the frontoparietotemporal region, affecting the cingulo-opercular connections which can interfere in patients’ executive functions, attention span and concentration. The objective of this study was to evaluate the executive functions, attention span and concentration of a sample of patients with NT1 and their correlation with the patients’ clinical and polysomnographic characteristics.Methods: We performed a transversal observational study with 15 patients diagnosed with NT1. Patients were submitted to neuropsychological tests such as the Trail Making Tests A (TMTA) and Trail Making Test B (TMTB), the Symbol-Digit test (WAIS code), the Toulouse-Piéron Cancellation test (TP), and the Stroop test (TS-CW). The obtained results were compared with the corresponding validated standardized values for the Portuguese population via Z-score calculation based on individual patients’ performance when compared to their peers. Afterwards, the obtained neuropsychological scores were correlated with their clinical and polysomnographic characteristics.Results: Based on the results of the neuropsychological tests, NT1 patients showed a worse overall performance in TP when compared to the general Portuguese population due to greater omission error dispersion index. No correlation was found in the neuropsychological test performances between patients’ clinical characteristics, such as excessive daytime sleepiness, and the overall sleep macrostructure or quality.Discussion: The lack of correlation between sleep quality and cognitive performance in NT1 patients suggests that their concentration and attention deficits may be related to the physiopathology of the disease ...