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Evidence for cognitive resource imbalance in adolescents with narcolepsy

Journal article
Authors Suzanne T Witt
Natasha Morales Drissi
Sofie Tapper
Anna Wretman
Attila Szakacs
Tove Hallböök
Anne-Marie Landtblom
Thomas Karlsson
Peter Lundberg
Maria Engström
Published in Brain imaging and behavior
Volume 12
Issue 2
Pages 411-424
ISSN 1931-7565
Publication year 2018
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 411-424
Language en
Subject categories Pediatrics


The study investigated brain activity changes during performance of a verbal working memory task in a population of adolescents with narcolepsy. Seventeen narcolepsy patients and twenty healthy controls performed a verbal working memory task during simultaneous fMRI and EEG acquisition. All subjects also underwent MRS to measure GABA and Glutamate concentrations in the medial prefrontal cortex. Activation levels in the default mode network and left middle frontal gyrus were examined to investigate whether narcolepsy is characterized by an imbalance in cognitive resources. Significantly increased deactivation within the default mode network during task performance was observed for the narcolepsy patients for both the encoding and recognition phases of the task. No evidence for task performance deficits or reduced activation within the left middle frontal gyrus was noted for the narcolepsy patients. Correlation analyses between the spectroscopy and fMRI data indicated that deactivation of the anterior aspect of the default mode in narcolepsy patients correlated more with increased concentrations of Glutamate and decreased concentrations of GABA. In contrast, deactivation in the default mode was correlated with increased concentrations of GABA and decreased concentrations of Glutamate in controls. The results suggested that narcolepsy is not characterized by a deficit in working memory but rather an imbalance of cognitive resources in favor of monitoring and maintaining attention over actual task performance. This points towards dysregulation within the sustained attention system being the origin behind self-reported cognitive difficulties in narcolepsy.

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