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Thalamic Activation in the Kleine-Levin Syndrome
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-2167-2450
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
2014 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 37, no 2, 379-386 p.Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVES:

The objective of this study was to investigate if combined measures of activation in the thalamus and working memory capacity could guide the diagnosis of Kleine-Levin Syndrome (KLS). A second objective was to obtain more insight into the neurobiological causes of KLS.

DESIGN:

Matched group and consecutive recruitment.

SETTING:

University hospital neurology department and imaging center.

PATIENTS OR PARTICIPANTS:

Eighteen patients with KLS diagnosed according to the International Classification of Sleep Disorders and 26 healthy controls were included.

INTERVENTIONS:

N/A.

MEASUREMENTS AND RESULTS:

Working memory capacity was assessed by the listening span task. A version of this task (reading span) was presented to the participants during functional magnetic resonance imaging (fMRI). Activation in the thalamus was measured in a region of interest analysis. A combination of the working memory capacity and the thalamic activation measures resulted in 80% prediction accuracy, 81% sensitivity, and 78% specificity regarding the ability to separate KLS patients from healthy controls. The controls had an inverse relation between working memory capacity and thalamic activation; higher performing participants had lower thalamic activation (r = -0.41). KLS patients showed the opposite relationship; higher performing participants had a tendency to higher thalamic activation (r = -0.35).

CONCLUSIONS:

This study shows that functional neuroimaging of the thalamus combined with neuropsychological assessment of working memory function provides a means to guide diagnosis of Kleine-Levin Syndrome. Results in this study also indicate that imaging of brain function and evaluation of cognitive capacity can give insights into the neurobiological mechanisms of Kleine-Levin Syndrome.

Place, publisher, year, edition, pages
United States: Associated Professional Sleep Societies, Llc , 2014. Vol. 37, no 2, 379-386 p.
Keyword [en]
Functional magnetic resonance imaging (fMRI), hypersomnia, narcolepsy, thalamus, working memory
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-104670DOI: 10.5665/sleep.3420ISI: 000332519100019PubMedID: 24497666OAI: oai:DiVA.org:liu-104670DiVA: diva2:698268
Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2017-12-05Bibliographically approved

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Engström, MariaKarlsson, ThomasLandtblom, Anne-Marie

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Division of Radiological SciencesFaculty of Health SciencesCenter for Medical Image Science and Visualization (CMIV)Disability ResearchFaculty of Arts and SciencesDivision of NeuroscienceDepartment of NeurologyDepartment of Medical Specialist in Motala
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