In humans, selective loss of orexin neurons is responsible for type 1 narcolepsy (NT1), or narcolepsy with cataplexy, or orexin deficiency syndrome. The International Classification of Sleep Disorders 3rd edition (ICSD-3) distinguishes between hypersomnolence of central origin: NT1, narcolepsy type 2 (NT2), or narcolepsy without cataplexy, and idiopathic hypersomnia (HI). These rare conditions are all characterised by hypersomnolence (excessive daytime sleepiness, or excessive need for sleep), which is the primary and often most disabling symptom. A level of ORX-A in cerebrospinal fluid (CSF) (\<110 pg/mL) is a very sensitive and specific biomarker of NT1, currently sufficient for the diagnosis of this condition. In contrast, ORX neurons are thought to be intact in IH and NT2, and the pathophysiological mechanisms underlying these diseases remain unknown. Thus, their diagnosis is based solely on clinical and electrophysiological criteria. The objective of this project is to determine the validity of a mass spectrometric technique for the determination of ORX-A in the cerebral spinal fluid of patients suffering from hypersomnolence in comparison with the radioimmunoassay which is the reference technique.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
117
ORX-A determination by quantitative mass spectrometry
University Hospital of Montpellier
Montpellier, France
RECRUITINGOrexin-A dosage by Multiple Reaction Monitoring Mass Spectrometry
Multiple Reaction Monitoring mass spectrometry for orexin-A dosage in cerebrospinal fluid
Time frame: Day 1 (=day of inclusion)
Orexin-A dosage by radioimmunoassay
Radioimmunoassay for orexin-A dosage in cerebrospinal fluid
Time frame: Day 1
Age of onset of hypersomnia symptoms
Time frame: Day 1
Frequency of cataplexy
Time frame: Up to 24 hours
Characteristics of cataplexy
Time frame: Up to 24 hours
Average duration of cataplexy
Time frame: Up to 24 hours
Epworth sleepiness scale (ESS)
the score will be between 0 and 24, higher scores mean a worse outcome
Time frame: Day 1
Narcolepsy severity scale (NSS)
the score will be between 0 and 57, higher scores mean a worse outcome
Time frame: Day 1
Hypersomnolence severity scale (IHSS)
the score will be between 0 and 50, higher scores mean a worse outcome
Time frame: Day 1
Insomnia severity index
the score will be between 0 and 32, higher scores mean a worse outcome
Time frame: Day 1
Iterative sleep latency tests (TILE)
Time frame: Up to 24 hours
Presence of the HLA allele DQB1*06:02
Time frame: Day 1
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