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The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery.
We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity.
Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared.
Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients.
This chapter reviews the approaches that have been used to identify genomic variation that may shape circadian entrainment and point new directions of research. It addresses some issues concerning study designs that may increase the efficiency of finding genetic components of the circadian clock in human. If the inter-individual differences in human time-of-day preference or in chronotype are extreme, they can manifest themselves as familial syndromes. The application of ethnicity markers is meanwhile a routine strategy in genome-wide association (GWA) studies. The GWA strategy is more reliable than a candidate gene approach. Human entrainment to different photoperiods may involve substantial plasticity in individual circadian period and phase of entrainment. High-throughput analyses are applied in circadian rhythms research. The authors have recently applied high-throughput genomics to identify alleles associated with phase of entrainment in extreme chronotypes.