Neurological

Narcolepsy in youngsters who’re unlikely to trigger mental incapacity

Narcolepsy in children was not the cause of intellectual disabilities; However, according to study results published in the Journal of Clinical Medicine, immediate interventions to manage comorbidities could improve cognitive performance in this population.

Study researchers at the Hôpital Femme Mere Enfant in France investigated the study of high cognitive functions in children with narcolepsy and whether this is a protective factor for school and behavioral disorders in this population.

This retrospective study included all children with idiopathic narcolepsy (N = 74) who were observed from 2010 to 2019 in a national reference center for narcolepsy in France. The patients were examined for clinical features and subjected to a neuropsychological evaluation. The parents of the children answered 4 questionnaires in which the sleepiness and the severity of the insomnia of their child were rated.

The majority of children included were boys (n = 43) with a mean age of 11.7 years at the time they were diagnosed with narcolepsy. Most of the children were obese (64%) or overweight (10%). All children were positive for the HLA-DR-DQB1 * 06:02 variant and all but 1 had low hypocretin-1 levels.

Almost half (48%) of the children had difficulties in school. Sleep disorders included cataplexy (91%), hypnagogic hallucinations (39%), and sleep paralysis (18%).

According to the polysomnography data, a minimal index of obstructive apnea-hypopnea (OAHI) was common (minimal saturation value 93%; range 30-98%), the sleep latency was a median of 4.8 (range 0-78) minutes, total sleep time was 478 (Range 270-615) minutes, sleep efficiency 84.1 percent (range 52.5-95.2%), sleep with rapid eye movements (REM) 22.3% (range 10.5-39.3%) and the total arousal index was 11.8% (range 0-66.6%).

Stratified by difficulty in school, no demographic, narcolepsy, polysomnographic measurements, or mental health traits were significantly different.

Compared to children with high potential (intelligence quotient [IQ]≥130) those without high potential had lower verbal comprehension (P <.0001), perceptual thinking (P <.0001), working memory (P <.0001), general skills (P <.0001), IQ (P <). 0001) and processing speed (P = .006).

The results showed a significant correlation between the percentage of REM sleep in children with narcolepsy and IQ (r, 0.25; P = 0.04). The higher the IQ, the more REM sleep a child had. A similar correlation tended towards a significant relationship between REM and IQ in children with (r, 0.37; P = 0.06) and without (r, 0.29; P = 0.05) high potential.

For every 1 percent increase in SEM, the multivariate regression model showed an increase in IQ of 0.58 (95% CI, 0.09-1.06; P = 0.02) points.

This study was constrained by the lack of a control group of children without narcolepsy, lack of information on parental IQ and educational level, and the cross-sectional design.

The study’s researchers concluded that, “Our results suggest that narcolepsy is unlikely to be a cause of intellectual disability in children, despite their frequent school difficulties. The neuropsychological examination could help these children to find appropriate support. “They added that” prompt diagnosis and treatment of comorbidities like obesity and OSA could improve cognitive performance and reduce school and behavioral disorders in these children. ”

reference

Thieux M., Zhang M., Marcastel A. et al. Intellectual Abilities of Children with Narcolepsy. J Clin Med. 2020; 9 (12): E4075. doi: 10.3390 / jcm9124075

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