Abstract：
REM sleep behaviour disorder (RBD) is common in narcolepsy type 1 (NT1). Abnormalities in the reward system have been observed in NT1, possibly related to impaired orexin projections towards the mesolimbic reward system, but also in RBD when associated with Parkinson\'s disease. Our study aimed to explore the psychobehavioural profile of NT1 patients with and without RBD compared with healthy controls (HC). Forty patients with NT1 were compared with 20 sex- and age-matched HC. All patients with NT1 underwent a video-polysomnography including a measure of REM sleep without atonia (RSWA). The following neuropsychobehavioural variables were assessed: apathy, impulsivity, depression, cognition, subjective and objective attention, sensation-seeking, and behavioural addictions. The patient population included 22 patients with NT1-RBD and 18 patients with NT1-noRBD. Compared with the healthy controls, patients with NT1 had higher scores of apathy, impulsivity, and depression; a lower score on global cognition, and poorer self-perceived attention. No differences were found between patients with NT1 with and without RBD in all neuropsychological variables, except for impaired objective attention in patients with NT1-RBD. In patients with NT1, a positive correlation was observed between RSWA and both apathy and impulsivity subscale. Moreover, in patients with NT1-RBD, RSWA was positively correlated with depression. Patients with NT1 showed higher depression, apathy, and impulsivity compared with controls. These measures correlate with the severity of RSWA, suggesting a transdiagnostic association between RBD and abnormalities of the reward system at least for patients with NT1.
摘要：
REM睡眠行为障碍（RBD）常见于1型发作性睡病（NT1）。在NT1中观察到奖励系统的异常，可能与对中脑边缘奖励系统的食欲素投影受损有关，但也在与帕金森病相关的RBD中。我们的研究旨在探讨与健康对照（HC）相比，有和没有RBD的NT1患者的心理行为特征。将40例NT1患者与20例性别和年龄匹配的HC进行比较。所有患有NT1的患者均接受了视频多导睡眠图检查，包括无张力的REM睡眠测量（RSWA）。评估了以下神经心理行为变量：冷漠，冲动,抑郁症,认知，主观和客观的注意，寻求感觉，和行为成瘾。患者群体包括22例NT1-RBD患者和18例NT1-noRBD患者。与健康对照组相比，NT1患者的冷漠评分较高，冲动,和抑郁症；全球认知得分较低，和较差的自我感知注意力。NT1伴和不伴RBD的患者在所有神经心理学变量中没有发现差异，除了NT1-RBD患者的客观注意力受损。在NT1患者中，RSWA与冷漠和冲动分量表之间呈正相关。此外，在NT1-RBD患者中，RSWA与抑郁呈正相关。NT1患者表现出更高的抑郁，冷漠,与对照组相比，冲动。这些措施与RSWA的严重程度相关，提示RBD与奖励系统异常之间存在跨诊断关联，至少对于NT1患者。
