Korean J Radiol.  2009 Dec;10(6):552-558. 10.3348/kjr.2009.10.6.552.

Gray Matter Concentration Abnormality in Brains of Narcolepsy Patients

• Joo EY
• Tae WS
• Kim ST
• Hong SB

• KMID: 1102557
• DOI: http://doi.org/10.3348/kjr.2009.10.6.552

Abstract

OBJECTIVE
To investigate gray matter concentration changes in the brains of narcoleptic patients. MATERIALS AND METHODS: Twenty-nine narcoleptic patient with cataplexy and 29 age and sex-matched normal subjects (mean age, 31 years old) underwent volumetric MRIs. The MRIs were spatially normalized to a standard T1 template and subdivided into gray matter, white matter, and cerebrospinal fluid (CSF). These segmented images were then smoothed using a 12-mm full width at half maximum (FWHM) isotropic Gaussian kernel. An optimized voxel-based morphometry protocol was used to analyze brain tissue concentrations using SPM2 (statistical parametric mapping). A one-way analysis of variance was applied to the concentration analysis of gray matter images. RESULTS: Narcoleptics with cataplexy showed reduced gray matter concentration in bilateral thalami, left gyrus rectus, bilateral frontopolar gyri, bilateral short insular gyri, bilateral superior frontal gyri, and right superior temporal and left inferior temporal gyri compared to normal subjects (uncorrected p < 0.001). Furthermore, small volume correction revealed gray matter concentration reduction in bilateral nuclei accumbens, hypothalami, and thalami (false discovery rate corrected p < 0.05). CONCLUSION: Gray matter concentration reductions were observed in brain regions related to excessive daytime sleepiness, cognition, attention, and memory in narcoleptics with cataplexy.

Keyword

Narcolepsy; Magnetic resonance (MR); Voxel based morphometry; Hypothalamus; Nucleus accumbens; Thalamus

MeSH Terms

Adult
Analysis of Variance
Brain/pathology/*radionuclide imaging
Case-Control Studies
Cataplexy/radionuclide imaging
Female
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Narcolepsy/pathology/*radionuclide imaging
Polysomnography

Figure

• 

  Fig. 1 Brain regions showing reduced gray matter concentrations in patients with narcolepsy and cataplexy.A. Overall areas showing reduced gray matter concentrations as whole are shown in glass brain view.B. Decreased gray matter concentrations in narcoleptics with cataplexy in: left gyrus rectus, bilateral thalami, bilateral frontopolar gyri, bilateral short insula gyri, bilateral superior frontal gyri, right superior temporal gyrus, and left inferior temporal gyrus are shown as T1 template overlaid MR image. Uncorrected p < 0.001 (extent threshold kE < 100 voxels).C. Bilateral nuclei accumbens (dotted arrows), bilateral hypothalamus (solid arrows), and bilateral thalami (arrowhead) showed reduced gray matter concentrations at false discovery rate level of corrected p < 0.05 with small volume correction. Superior to inferior panels are arranged in anterior to posterior direction in coronal images. Left-hand sides of images represent left side of brain.

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