Clinical and neurophysiological data of patients having narcolepsy with and without cataplexy.

<p>Continuous values are expressed as mean±SD.</p><p>*p<0.05(t-test).</p><p>JESS: Epworth Sleepiness Scale, Japanese version.</p><p>MSLT: multiple sleep latency test.</p

Clusters showing significant main effects of group on ADC and FA values between the narcolepsy with cataplexy (NA/CA) and narcolepsy without cataplexy (NA w/o CA) groups.

<p>a) ADC value was higher in the right inferior frontal gyrus (Brodmann area 9) for the NA/CA group than for the NA w/o CA group. b) In the NA/CA group, the FA value in the right parietal lobe (precuneus) was higher than that in the NA w/o CAgroup. Results are significant at FWE-corrected p<0.05. Color scale is for F statistic.</p

Significant differences in the ADC and FA values for the NA/CA, NA w/o CA, and NC groups.

<p>Height threshold uncorrected p<0.001 in peak level on ANOVA.</p><p>Group main effects in cluster-level by multiple voxel-wise comparisons using P_FWE-corr: family-wise error, corrected p.</p><p>NA/CA: narcolepsy with cataplexy, NA w/o CA: narcolepsy without cataplexy, NC: normal controls.</p><p>ADC: apparent diffusion coefficient, FA: fractional anisotropy.</p

Clusters showing significant main effects of group on ADC value between patients having narcolepsy with cataplexy (NA/CA) and normal control (NC).

<p>1-1) ADC values were higher in the left parahippocampal gyrus (Brodmann area 34) and amygdala, and 1-2) in the left inferior frontal gyrus (Brodmann area 47/11) in NA/CA than in NC, while these values were lower in 2) the left postcentral gyrus (Brodmann area 3) in the former group. pone.0081059.Results.tifare significant at FWE-corrected p<0.05. Color scale is for F statistic.</p

The Prevalence and Characteristics of Primary Headache and Dream-Enacting Behaviour in Japanese Patients with Narcolepsy or Idiopathic Hypersomnia: A Multi-Centre Cross-Sectional Study

<div><p>Background</p><p>Because the prevalence and characteristics of primary headache have yet to be thoroughly studied in patients with hypersomnia disorders, including narcolepsy and idiopathic hypersomnia, we examined these parameters in the Japanese population.</p><p>Methods</p><p>In a multicentre cross-sectional survey, among 576 consecutive outpatients with sleep disorders, 68 narcolepsy patients and 35 idiopathic hypersomnia patients were included. Additionally, 61 healthy control subjects participated. Semi-structured headache questionnaires were administered to all participants.</p><p>Results</p><p>The patients with narcolepsy (52.9%) and idiopathic hypersomnia (77.1%) more frequently experienced headache than the healthy controls (24.6%; <i>p</i><0.0001). The prevalence rates were 23.5%, 41.2% and 4.9% for migraine (<i>p</i><0.0001) and 16.2%, 23.5% and 14.8% (<i>p</i> = 0.58) for tension-type headache among the narcolepsy patients, the idiopathic hypersomnia patients and the control subjects, respectively. Those who experienced migraine more frequently experienced excessive daytime sleepiness, defined as an Epworth Sleepiness Scale score of ≥10, than those who did not experience headache among the patients with narcolepsy (93.8% vs. 65.6%, <i>p</i> = 0.040) and idiopathic hypersomnia (86.7% vs. 37.5%, <i>p</i> = 0.026). Dream-enacting behaviour (DEB), as evaluated by the rapid eye movement sleep disorders questionnaire, was more frequently observed in the narcolepsy patients than in the idiopathic hypersomnia patients and the control subjects. An increased DEB frequency was observed in the narcolepsy patients with migraines compared to those without headache.</p><p>Conclusions</p><p>Migraines were frequently observed in patients with narcolepsy and idiopathic hypersomnia. DEB is a characteristic of narcolepsy patients. Further studies are required to assess the factors that contribute to migraines in narcolepsy and idiopathic hypersomnia patients.</p></div

Characteristics of the idiopathic hypersomnia patients with migraines and those without headache.

<p>Except where otherwise noted, means±SDs are given. Statistically significant values (p<0.05) are shown in bold. ESS, Epworth Sleepiness Scale; PSQI, Pittsburgh Sleep Quality Index; BDI-II, Beck Depression Inventory-II; RBDSQ-J, the Japanese version of the rapid eye movement sleep behaviour disorder screening questionnaire.</p><p>Characteristics of the idiopathic hypersomnia patients with migraines and those without headache.</p

Flow chart of the patient selection method.

<p>Flow chart of the patient selection method.</p

Polysomnographic findings in narcolepsy patients with migraine and narcolepsy patients without headache.

<p>Except where otherwise noted, means±SDs are provided. Statistically significant values (p<0.05) are shown in bold.</p><p>PSG, polysomnography; REM, rapid eye movement; WASO, wake after sleep onset; AHI, apnoea-hypopnoea index; ODI, oxygen desaturation index; PLMS, periodic limb movement in sleep; MSLT, multiple sleep latency test; SOREMP, sleep-onset REM periods.</p><p>Polysomnographic findings in narcolepsy patients with migraine and narcolepsy patients without headache.</p

Polysomnographic findings in idiopathic hypersomnia patients with migraine and idiopathic hypersomnia patients without headache.

<p>Except where otherwise noted, means±SDs are provided.</p><p>PSG, polysomnography; REM, rapid eye movement; WASO, wake after sleep onset; AHI, apnoea-hypopnoea index; ODI, oxygen desaturation index; PLMS, periodic limb movement in sleep; MSLT, multiple sleep latency test; SOREMP, sleep-onset REM periods.</p><p>Polysomnographic findings in idiopathic hypersomnia patients with migraine and idiopathic hypersomnia patients without headache.</p

Clinical background of the narcolepsy and idiopathic hypersomnia patients and the control subjects.

<p>Except where otherwise noted, means±SDs are given.</p><p>*p<0.05 compared to the narcolepsy patient group;</p><p>^¶p<0.05 compared to the idiopathic hypersomnia patient group. Statistically significant values (p<0.05) are shown in bold.</p><p>ESS, Epworth Sleepiness Scale; PSQI, Pittsburgh Sleep Quality Index; BDI-II, Beck Depression Inventory-II; RBDSQ-J, the Japanese version of the rapid eye movement sleep behaviour disorder screening questionnaire.</p><p>Clinical background of the narcolepsy and idiopathic hypersomnia patients and the control subjects.</p