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Bakgrund: Narkolepsi är en kronisk neurologisk sjukdom som påverkar hjärnans förmåga att reglera hormonet hypokretin, vars uppgift är att reglera aptit, sömn och vakenhet. Narkolepsi delas in i två typer, Typ 1 och Typ 2. Fysisk inaktivitet har påvisat öka besvären med överväldigande dagtrötthet och personer med narkolepsi är mindre fysiskt aktiva än friska personer.  Syfte: Undersöka och kartlägga hälsorelaterad livskvalitet och fysisk aktivitet hos en grupp individer med narkolepsi, jämföra åldersskillnader samt undersöka om det finns ett samband mellan dessa variabler.  Metod: Tvärsnittsstudie med icke-experimentell design. Individer från 16 år inkluderades i undersökningsgruppen (n=70). Deltagarna rekryterades via Narkolepsiföreningen genom en sluten Facebook-grupp och ett mejlutskick från deras kansli.  Resultat: Lägre dimensionspoäng inom samtliga dimensioner från RAND-36 kunde påvisas för deltagarna jämfört med normalpopulationen samt att majoriteten av deltagarna uppnår rekommendationerna för fysisk aktivitet per vecka. Signifikant skillnad mellan åldersgrupperna kunde enbart påvisas inom dimensionerna Rollfunktion (emotionell) och Psykiskt välbefinnande. Det fanns en signifikant positiv låg korrelation mellan rapporterade aktivitetsminuter och dimensionen Fysisk funktion.  Konklusion: Resultatet i undersökningen visar på trots att majoriteten av deltagarna uppnår rekommendationerna för fysisk aktivitet skattade de lågt för dimensioner kopplade till psykologiska och sociala aspekter. Det behövs således vidare forskning för att undersöka olika fysiska interventioners effekt på den hälsorelaterade livskvaliteten hos individer med narkolepsi. Resultatet visar även på att det finns ett behov av multimodalt bemötande med fokus på bio-psyko-sociala aspekterna. / Background: Narcolepsy is a chronic neurological illness that effects the brain’s capacity to produce the hypocretin hormone, whose function is to regulate appetite, sleep and alertness. Narcolepsy is divided into two groups, Type 1 and Type 2. Physical inactivity has shown to increase the symptoms of excessive daytime sleepiness and individuals with narcolepsy is less physically active than healthy individuals.  Purpose: To study and chart health-related quality of life and physical activity level in a group of individuals with narcolepsy, to compare age-differences and also to explore whether there is a correlation between these variables.  Method: Cross-sectional study with a non-experimental design. Participants from 16 years old were included in the sample group (n=70). The participants were recruited by Narkolepsiföreningen through a closed Facebook-group and through e-mail from their chancellery.  Results: A lower score within all dimensions could be shown for the participants and that the majority of the participants reach the recommendation for physical activity each week. A significantly difference between the age-groups was disclosed within the dimensions Social functioning and Mental health. There was a significant positive low correlation between reported physical activity levels and the dimension Physical function.  Conclusion: The results in this study show that even though the majority of the participants reach the recommendations for physical activity, the dimensions that were related to psychological and social aspects were low. Thus, further research is needed to study the effect of different physical interventions on the health-related quality of life in individuals with narcolepsy. The results also show that there is a need for a multimodal approach with focus on the biological, psychological and social aspects.

Narcolepsy is a disorder of unstable wake and sleep states caused by the lack of orexin neurons which degenerate most likely as a consequence of an autoimmune process. The state instability of narcolepsy includes rapid eye movement (REM) sleep intruding into wake in the form of dream-like hallucinations and cataplexy, muscle paralysis (atonia) much like occurs in REM sleep. In mice lacking orexin peptides, cataplexy is also observed with similar presentation as in humans of muscle paralysis during wakefulness which is often triggered by positive emotions. Prior research showed that the activation of the central amygdala is sufficient to promote cataplexy in a mouse model of narcolepsy. The central amygdala (CeA) contains a variety of neuronal types, and we hypothesize that γ-aminobutyric acid (GABA)-ergic neurons expressing the oxytocin receptor (OTR) mediate cataplexy as these neurons project to a known REM sleep atonia-regulating region, the ventrolateral periaqueductal gray (vlPAG)/lateral pontine tegmentum (LPT), and, as oxytocin (OT) sensitive neurons in the amygdala, likely participate in emotional processing and social behavior. In this study, we used fiber photometry to investigate the behavior of these neurons in response to social and rewarding stimuli, during emotion-triggered cataplexy, and across arousal states in an effort to define their potential role in emotion-triggered cataplexy. Initial recordings were conducted at too low an excitation light power to stimulate the green fluorescent calcium indicator, GCaMP6s, but were useful in optimizing MATLAB analysis and behavioral tests later done at higher LED power. The second series of recordings with higher excitation light power and better signal to noise ratio, showed increased activity in response to social interaction and reward, prior to REM transitions, and decreased activity during cataplexy confirming patterns seen in initial recordings. In recordings with higher excitation light, these responses appear to occur before interaction with stimulus mice or reward stimulus. In the future, additional recordings with a higher signal to noise ratio will be needed to confirm these results. In conclusion, responses of CeA-OTR neurons to social and rewarding stimuli, cataplexy, and at REM transitions are in support of a possible role of these neurons in emotion-triggered cataplexy which can be tested using additional methods, such as optogenetics.

INTRODUÇÃO: É um estudo pioneiro na avaliação de diversos tipos de atenção e de memória em pacientes brasileiros com narcolepsia. A narcolepsia é um distúrbio crônico do sono cujo principal sintoma é a Sonolência Diurna Excessiva (SDE) e a ocorrência de ataques súbitos diurnos de sono REM (Rapid Eye Movement Movimento Rápido dos Olhos), especialmente em situações monótonas. Pode estar associada a episódios de cataplexia (repentina redução ou perda do tônus muscular, sem perda de consciência), paralisia do sono (dificuldade para mover-se logo ao adormecer ou acordar) e a alucinações hipnagógicas ou hipnopômpicas (imagens oníricas que invadem o estado de vigília) antes de adormecer ou logo ao acordar, respectivamente. OBJETIVOS: Avaliar o padrão, a qualidade do sono, a ocorrência de SDE, os sinais e sintomas depressivos, a atenção orientada/seletiva, sustentada e executiva, as memórias imediata, tardia e de trabalho e verificar associações entre sono, sinais e sintomas depressivos e as funções neuropsicológicas. MÉTODO: O grupo-estudo compôs-se de 19 pacientes com narcolepsia, medicados e tratados em Ambulatório, com idades entre 22 e 51 anos (média = 37,58; dp = 8,93), comparados a 19 sujeitos sem distúrbios do sono, com idades entre 19 e 55 anos (média = 34,42; dp = 12,31) do grupo-controle. Os instrumentos utilizados foram: Entrevista inicial, Classificação Econômica Brasil (CEB), Escala de Sonolência de Epworth - Versão em Português do Brasil (ESSBR), Índice da Qualidade de Sono de Pittsburgh Versão em Português do Brasil (PSQI-BR), Teste de Raven, Escala de Hamilton para Avaliação da Depressão (HAM-D), Teste d2, Victoria Stroop Test (VST),Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), The Rivermead Behavioural Memory Test II (RBMT-II), WAIS III: Subtestes Sequência de Números e Letras (SNL), Dígitos Ordens Direta e Inversa e as Figuras de Rey. RESULTADOS: Os grupos foram homogêneos quanto às variáveis sociodemográficas. O padrão e a qualidade do sono estiveram significativamente prejudicados nos sujeitos do grupo-estudo: Distúrbios (p=0,007), SDE + distúrbios (p<0,001) e SDE (p<0,001). O grau de sinais e sintomas depressivos foi maior para os sujeitos do grupo-estudo (p=0,003). O desempenho dos grupos foi equivalente quanto à atenção orientada/seletiva e sustentada e de memórias imediata e tardia visual. Os sujeitos do grupo-estudo foram mais lentos no VST-1 (p=0,002) e 2 (p=0,045) e no TMT, com prejuízo na atenção dividida (p=0,024). A memória imediata e tardia verbal mostrou-se prejudicada somente em alguns ensaios do RAVLT. Os resultados da SNL foram piores para os sujeitos do grupoestudo (p=0,009). As correlações entre o sono, o grau de sinais e sintomas depressivos e o desempenho neuropsicológico foram diferentes para cada grupo. CONCLUSÕES: Os pacientes com narcolepsia tiveram maior prejuízo quanto ao padrão e qualidade do sono, à SDE, à presença de sinais e sintomas depressivos, à atenção executiva e à memória de trabalho em relação aos sujeitos do grupo-controle. Os resultados da atenção orientada/seletiva e sustentada e das memórias imediata e tardia verbal e visual não diferiram entre os grupos. Não se confirmou a ocorrência de associações entre a SDE e o desempenho neuropsicológico que justificasse as queixas subjetivas dos pacientes de déficits de atenção e memória / INTRODUCTION: A pioneering study on the neuropsychological assessment of several types of attention and memory in Brazilian narcoleptic outpatients. Narcolepsy is a chronic sleep disorder which the main symptoms are Excessive Daytime Sleepiness (EDS) and the occurrence of Rapid Eye Movements (REM) daytime sleep attacks, particularly during monotonous situations. Narcolepsy may be associated with episodes of cataplexy (sudden reduction or loss of muscular tonus not accompanied by loss of consciousness), sleep paralysis (inability to move at falling asleep or waking up) and hypnagogic or hypnopompic hallucinations (onirical images that pervade the state of wakefulness) before falling asleep or at waking up, respectively. OBJECTIVES: To evaluate the standard, the quality of sleep, the presence of EDS, traits and symptoms of depression, selective/oriented, sustained and executive attention, immediate, late and working memories, and verify associations among sleep, traits and symptoms of depression and neuropsychological functions. METHOD: The study group comprised 19 narcoleptic outpatients treated at the Neurology Clinic, ages ranging from 22 to 51 years (mean = 38.00; sd = 8.93), compared with 19 subjects not suffering from sleep disorders, ages ranging from 19 to 55 years (mean = 34.42; sd = 12.31) of control group. The material employed in the study included: preliminary interview, Brazil Economic Classification (CEB), Epworth Sleepiness Scale Brazilian Portuguese Version (ESS-BR), Pittsburgh Sleep Quality Index Brazilian Portuguese Version (PSQI-BR), Ravens Progressive Matrices (RPM), Hamilton Rating for Depression (HAMD), d2 Test, Victoria Stroop Test (VST), Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), The Rivermead Behavioural Memory Test II (RBMT-II), WAIS-III: Letter-Number Sequencing (SNL), Digit Span Forward and Backward Subtests and Rey-Osterrieth Complex Figure Test. RESULTS: The groups were homogeneous in sociodemographic variables. Standard and quality of sleep were significantly impaired in the subjects of study group: Disorders (p = 0.007), EDS + disorders (p < 0.001) and EDS (p < 0.001). Traits and symptoms degrees of depression was higher for subjects of study group (p = 0.003). Performance of both groups was equivalent as to oriented/selective and sustained attention besides immediate and late visual memories. Subjects of study group were slower at VST-1 (p = 0.002) and VST-2 (p = 0.045) and at TMT, impaired at divided attention (p = 0.024). Immediate and late verbal memories were impaired only at some RAVLT trials. SNL results were worse for subjects of study group (p = 0.009). Correlations among sleep, traits and symptoms degrees of depression and neuropsychological performance were different for each group. CONCLUSIONS: Narcoleptic patients presented greater impairment in the standard and quality of sleep, EDS, occurrence of traits and symptoms of depression, executive attention and working memory when matched with subjects of the control group. The results of oriented/selective and sustained attention and those of immediate and late verbal and visual memories showed no differences between the groups. Association between EDS and neuropsychological performance which might justify patients subjective complaints about deficits of attention and memory were not confirmed

INTRODUÇÃO: É um estudo pioneiro na avaliação de diversos tipos de atenção e de memória em pacientes brasileiros com narcolepsia. A narcolepsia é um distúrbio crônico do sono cujo principal sintoma é a Sonolência Diurna Excessiva (SDE) e a ocorrência de ataques súbitos diurnos de sono REM (Rapid Eye Movement Movimento Rápido dos Olhos), especialmente em situações monótonas. Pode estar associada a episódios de cataplexia (repentina redução ou perda do tônus muscular, sem perda de consciência), paralisia do sono (dificuldade para mover-se logo ao adormecer ou acordar) e a alucinações hipnagógicas ou hipnopômpicas (imagens oníricas que invadem o estado de vigília) antes de adormecer ou logo ao acordar, respectivamente. OBJETIVOS: Avaliar o padrão, a qualidade do sono, a ocorrência de SDE, os sinais e sintomas depressivos, a atenção orientada/seletiva, sustentada e executiva, as memórias imediata, tardia e de trabalho e verificar associações entre sono, sinais e sintomas depressivos e as funções neuropsicológicas. MÉTODO: O grupo-estudo compôs-se de 19 pacientes com narcolepsia, medicados e tratados em Ambulatório, com idades entre 22 e 51 anos (média = 37,58; dp = 8,93), comparados a 19 sujeitos sem distúrbios do sono, com idades entre 19 e 55 anos (média = 34,42; dp = 12,31) do grupo-controle. Os instrumentos utilizados foram: Entrevista inicial, Classificação Econômica Brasil (CEB), Escala de Sonolência de Epworth - Versão em Português do Brasil (ESSBR), Índice da Qualidade de Sono de Pittsburgh Versão em Português do Brasil (PSQI-BR), Teste de Raven, Escala de Hamilton para Avaliação da Depressão (HAM-D), Teste d2, Victoria Stroop Test (VST),Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), The Rivermead Behavioural Memory Test II (RBMT-II), WAIS III: Subtestes Sequência de Números e Letras (SNL), Dígitos Ordens Direta e Inversa e as Figuras de Rey. RESULTADOS: Os grupos foram homogêneos quanto às variáveis sociodemográficas. O padrão e a qualidade do sono estiveram significativamente prejudicados nos sujeitos do grupo-estudo: Distúrbios (p=0,007), SDE + distúrbios (p<0,001) e SDE (p<0,001). O grau de sinais e sintomas depressivos foi maior para os sujeitos do grupo-estudo (p=0,003). O desempenho dos grupos foi equivalente quanto à atenção orientada/seletiva e sustentada e de memórias imediata e tardia visual. Os sujeitos do grupo-estudo foram mais lentos no VST-1 (p=0,002) e 2 (p=0,045) e no TMT, com prejuízo na atenção dividida (p=0,024). A memória imediata e tardia verbal mostrou-se prejudicada somente em alguns ensaios do RAVLT. Os resultados da SNL foram piores para os sujeitos do grupoestudo (p=0,009). As correlações entre o sono, o grau de sinais e sintomas depressivos e o desempenho neuropsicológico foram diferentes para cada grupo. CONCLUSÕES: Os pacientes com narcolepsia tiveram maior prejuízo quanto ao padrão e qualidade do sono, à SDE, à presença de sinais e sintomas depressivos, à atenção executiva e à memória de trabalho em relação aos sujeitos do grupo-controle. Os resultados da atenção orientada/seletiva e sustentada e das memórias imediata e tardia verbal e visual não diferiram entre os grupos. Não se confirmou a ocorrência de associações entre a SDE e o desempenho neuropsicológico que justificasse as queixas subjetivas dos pacientes de déficits de atenção e memória / INTRODUCTION: A pioneering study on the neuropsychological assessment of several types of attention and memory in Brazilian narcoleptic outpatients. Narcolepsy is a chronic sleep disorder which the main symptoms are Excessive Daytime Sleepiness (EDS) and the occurrence of Rapid Eye Movements (REM) daytime sleep attacks, particularly during monotonous situations. Narcolepsy may be associated with episodes of cataplexy (sudden reduction or loss of muscular tonus not accompanied by loss of consciousness), sleep paralysis (inability to move at falling asleep or waking up) and hypnagogic or hypnopompic hallucinations (onirical images that pervade the state of wakefulness) before falling asleep or at waking up, respectively. OBJECTIVES: To evaluate the standard, the quality of sleep, the presence of EDS, traits and symptoms of depression, selective/oriented, sustained and executive attention, immediate, late and working memories, and verify associations among sleep, traits and symptoms of depression and neuropsychological functions. METHOD: The study group comprised 19 narcoleptic outpatients treated at the Neurology Clinic, ages ranging from 22 to 51 years (mean = 38.00; sd = 8.93), compared with 19 subjects not suffering from sleep disorders, ages ranging from 19 to 55 years (mean = 34.42; sd = 12.31) of control group. The material employed in the study included: preliminary interview, Brazil Economic Classification (CEB), Epworth Sleepiness Scale Brazilian Portuguese Version (ESS-BR), Pittsburgh Sleep Quality Index Brazilian Portuguese Version (PSQI-BR), Ravens Progressive Matrices (RPM), Hamilton Rating for Depression (HAMD), d2 Test, Victoria Stroop Test (VST), Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), The Rivermead Behavioural Memory Test II (RBMT-II), WAIS-III: Letter-Number Sequencing (SNL), Digit Span Forward and Backward Subtests and Rey-Osterrieth Complex Figure Test. RESULTS: The groups were homogeneous in sociodemographic variables. Standard and quality of sleep were significantly impaired in the subjects of study group: Disorders (p = 0.007), EDS + disorders (p < 0.001) and EDS (p < 0.001). Traits and symptoms degrees of depression was higher for subjects of study group (p = 0.003). Performance of both groups was equivalent as to oriented/selective and sustained attention besides immediate and late visual memories. Subjects of study group were slower at VST-1 (p = 0.002) and VST-2 (p = 0.045) and at TMT, impaired at divided attention (p = 0.024). Immediate and late verbal memories were impaired only at some RAVLT trials. SNL results were worse for subjects of study group (p = 0.009). Correlations among sleep, traits and symptoms degrees of depression and neuropsychological performance were different for each group. CONCLUSIONS: Narcoleptic patients presented greater impairment in the standard and quality of sleep, EDS, occurrence of traits and symptoms of depression, executive attention and working memory when matched with subjects of the control group. The results of oriented/selective and sustained attention and those of immediate and late verbal and visual memories showed no differences between the groups. Association between EDS and neuropsychological performance which might justify patients subjective complaints about deficits of attention and memory were not confirmed

Thesis (Ph. D.) -- University of Texas Southwestern Medical Center at Dallas, 2005. / Vita. Bibliography: 255-274.

Brain Activation Sequences Abstract INTRODUCTION: This research goes beyond the EEG source localization up to the field of brain connectivity in an attempt to create software tool that eases diagnostic procedures in selected nosologic units by discriminating between patients and healthy controls. METHODS: Experiment 1 - a group of 26 adult patients (14 male, 12 female) suffering from NC and 10 adult controls (5 male, 5 female) participated in the experiment. The experiment contained audio recordings designed to trigger laughter in participants during the EEG recording. Experiment 2 - twenty eight female inpatients diagnosed with ED and ten healthy controls were selected and presented with various stimuli while the EEG was recorded. The Brain Activation Sequences method, applied to all recordings, utilizes nonlinear differential model structure to calculate final output sequence of the brain locations involved substantially in the stimulus processing. RESULTS: Experiment 1 - the BAS results show statistically significant differences in activity between patients and controls namely in gyrus orbitalis, rectus, occipitalis inferior (right), occipitalis medius (right), paracentralis, cinguli, cuneus (right) and parahippocampalis (left). Experiment 2 - the results confirm significant differences in processing the...

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Introduction : La narcolepsie et l'hypersomnie idiopathique sont des troubles d'hypersomnie centrale peu compris, caractérisés par une somnolence diurne excessive causant des perturbations majeures au niveau du fonctionnement diurne et de la qualité de vie. Bien que certains aspects cliniques soient propres à chaque condition, plusieurs caractéristiques se chevauchent et ces dernières demeurent très difficile à diagnostiquer adéquatement. Le manque de distinction entre les troubles d'hypersomnolence centrale est extrêmement problématique, limitant la compréhension des mécanismes physiopathologiques sous- jacents. Objectif : À l'aide de la morphométrie cérébrale, l'objectif de l'étude est d'établir des différences anatomiques (c.-à-d., épaisseur corticale, volume sous-cortical) entre la narcolepsie avec cataplexie (NT1), la narcolepsie sans cataplexie (NT2), l'hypersomnie idiopathique (HI) et des participants en santé contrôles dans diverses régions du cerveau qui sont fonctionnellement liées au sommeil et au maintien de l'éveil. Méthodes : Une séquence d’acquisition d’images IRM anatomiques pondérées en T1 fut acquise sur 15 patients NT1, 15 NT2, 15 HI et 15 participants contrôles en santé (n = 60). Les images anatomiques furent traitées avec la suite logicielle FreeSurfer (FreeSurfer version 6.0.1) afin d'obtenir des mesures d'épaisseur corticale et de volume sous-cortical. Les mesures morphométriques obtenus pour différentes régions furent comparées entre les groupes par ANOVAs, ajustées pour l'âge. Résultats : Les résultats ont démontré une réduction volumétrique de la matière grise dans plusieurs structures sous-corticales associées au sommeil et au maintien de l'éveil dont l'hypothalamus et l'amygdale pour les patients NT1 et les patients NT2, comparés aux participants contrôles en santé. Les patients HI quant à eux n'ont pas démontré de différence volumétrique au niveau de l'hypothalamus comparativement aux participants contrôles, mais plutôt une diminution du volume de l'amygdale et du noyau accumbens, des structures associées à un réseau fonctionnel modulant la vigilance. Aucune différence significative d'épaisseur corticale n'a été retrouvée entre les groupes. Conclusion : Les résultats montrent des changements neuroanatomiques distincts entre les patients NT1 et HI, suggérant des mécanismes physiopathologiques différents et soulignent le phénotype hétérogène des patients NT2. / Introduction : Narcolepsy and idiopathic hypersomnia are poorly understood central disorders of hypersomnolence characterized by excessive daytime sleepiness leading to severe daytime disturbances and poor quality of life. Although some clinical features are specific to each condition, many characteristics overlap, and a reliable diagnosis remains difficult to achieve. The lack of clinical distinction between central disorders of hypersomnolence is extremely problematic and hinders the understanding of their underlying pathophysiological mechanisms. Objective : Using brain morphometry, the objective of this study is to establish anatomical differences (i.e., cortical thickness and subcortical volume) between narcolepsy with cataplexy (NT1), narcolepsy without cataplexy (NT2), idiopathic hypersomnia (HI) and healthy controls in brain regions involved in the modulation of sleep and wakefulness. Methods : T1-weighted MRI sequences were acquired in 15 NT1 patients, 15 NT2, 15 HI and 15 healthy controls (n = 60). Anatomical images were preprocessed using the FreeSurfer software package (FreeSurfer version 6.0.1) to obtain measures of cortical thickness and subcortical volume. Group differences in brain morphometric measurements acquired for different brain regions were analyzed using ANOVAs, adjusted for age. Results : Results displayed reduced gray matter volume in subcortical structures associated with the modulation of sleep and wakefulness, including the hypothalamus and the amygdala in NT1 and NT2 patients, compared to healthy controls. On the other hand, HI patients did not show volume changes in the hypothalamus compared to healthy controls, but instead showed a volume reduction of the amygdala and the nucleus accumbens, both structures associated with a functional network involved in the modulation of alertness. No significant group difference in cortical thickness was found. Conclusion : These results show distinct neuroanatomical changes between NT1 patients and HI patients, suggesting separate pathophysiological mechanisms and underline the heterogeneous phenotype of NT2 patients.

Introduction : Les analyses de connectivité cérébrale dans les trois troubles majeurs d'hypersomnolence centrale, la narcolepsie de type I (NT1), de type II (NT2) et de l’hypersomnie idiopathique (HI) sont rares dans la littérature. Les études de connectivité structurelle indiquent comment les réseaux de fibres de matière blanche sont organisés et affectés dans le cas de patients atteints de troubles du système nerveux central. L’objectif principal de cette étude est d’observer si la connectivité structurelle est affectée dans la NT1, NT2 et l’HI comparativement à des sujets sains. Une diminution dans les mesures de connectivité globale dans les troubles d’hypersomnolence centrale et leur association à la sévérité des symptômes comme la somnolence sont supposées. Méthodes : Des sujets sains (HC, n=8) et des patients diagnostiqués avec soit l’HI (n=14), la NT1 (n=15) ou la NT2 (n=14) ont suivi une séance d'IRM avec l’imagerie pondérée en diffusion. Les mesures d’intégration (efficacité globale) et de ségrégation (efficacité locale et transitivité), l’index de petit monde, et le degré nodal ont été utilisés. Les variables cliniques d’inertie de sommeil, la somnolence, la dépression, l’anxiété, la sévérité d’hypersomnolence et la durée symptomatique ont été évaluées. Résultats et conclusion : Seul le groupe HI a démontré une efficacité globale significativement plus élevée que le groupe HC, qui pourrait être expliquée par une augmentation de la transmission GABAergique. Le groupe NT2 a démontré une association entre l’efficacité globale et les scores au ESS et HSI. Aucune autre différence significative n’a été démontrée pour les autres mesures globales ni pour les mesures régionales entre les groupes. / Introduction: Structural connectivity studies comparing all three central primary hypersomnolence disorder types, i.e., narcolepsy type I (NT1), type II (NT2) and idiopathic hypersomnia (IH) have been scarce. Differences in structural connectivity may indicate how circuits in the brain are affected in hypersomnolence disorders compared to healthy controls. The main goal of this study is to assess if differences exist between NT1, NT2 and IH patients compared to controls using structural imaging analyses. A decrease in global connectivity measures in all three central hypersomnolence disorders compared to healthy controls and an association to symptom severity like sleepiness is hypothesized. Methods: Patients diagnosed with either NT1 (n=15), NT2 (n=13) or IH (n=14), as well as healthy participants (HC, n=8) were recruited and underwent a DWI session. Data were preprocessed and analyzed using a model based on constrained spherical deconvolution with multi-shell and multi-tissue parameters. Integration (global efficiency) and segregation measures, small-world index and nodal degree were used to evaluate structural connectivity. Clinical variables of sleep inertia, sleepiness, hypersomnia severity, depression, anxiety, and disease duration were evaluated. Results and conclusion: Only IH patients showed a significantly higher global efficiency than HC. An increase in GABAergic transmission is a potential mechanism, but how it relates to IH symptoms is unclear. Global efficiency was also demonstrated to be associated with ESS and HSI scores in the NT2 group. There were no differences between groups for any of the other global or local measures.