We present behavioral and functional magnetic resonance imaging (fMRI) findings of a 20-year-old female with narcolepsy who completed a standardized fMRI-adapted face memory task both 'off' and 'on' modafinil compared to a normative sample (N = 38). The patient showed poor recognition performance off modafinil (z = -2.03) but intact performance on modafinil (z = 0.78). fMRI results showed atypical activation during memory encoding off modafinil, with frontal lobe hypoactivity, but hippocampal hyperactivity, whereas all brain regions showed more normalized activation on modafinil. Results from this limited study suggest hippocampal and frontal alterations in individuals with narcolepsy. Further, the results suggest the hypothesis that modafinil may affect brain activation in some people with narcolepsy.
"This finding must, however, be validated by comparing fMRI in KLS and other differential diagnosis. In narcolepsy, fMRI has been used to investigate the relation between brain activation and pharmacological therapy (46–48). Although results were promising, they remain hypothetical until validated in larger patient groups. "
[Show abstract][Hide abstract] ABSTRACT: This work aims at reviewing the present state of the art when it comes to understanding the pathophysiology of narcolepsy and the Kleine–Levin syndrome (KLS) from a neuroimaging point of view.This work also aims at discussing future perspectives of functional neuroimag-ing in these sleep disorders. We focus on functional magnetic resonance imaging (fMRI), which is a technique for in vivo measurements of brain activation in neuronal circuitries under healthy and pathological conditions. fMRI has significantly increased the knowledge on the affected neuronal circuitries in narcolepsy and the Kleine–Levin syndrome. It has been shown that narcolepsy is accompanied with disturbances of the emotional and the closely related reward systems. In the Kleine Levin syndrome, fMRI has identified hyper-activation of the thalamus as a potential biomarker that could be used in the diagnostic procedure. The fMRI findings in both narcolepsy and the Kleine–Levin syndrome are in line with previous structural and functional imaging studies. We conclude that fMRI in combi-nation with multi-modal imaging can reveal important details about the pathophysiology in narcolepsy and the Kleine–Levin syndrome. In the future, fMRI possibly gives opportunities for diagnostic support and prediction of treatment response in individual patients.
Frontiers in Neurology 06/2014; 5. DOI:10.3389/fneur.2014.00105
[Show abstract][Hide abstract] ABSTRACT: It has been established that oxidative stress, defined as the condition when the sum of free radicals in a cell exceeds the antioxidant capacity of the cell, contributes to the pathogenesis of Parkinson's disease. Glutathione is a ubiquitous thiol tripeptide that acts alone, or in concert with enzymes within cells to reduce superoxide radicals, hydroxyl radicals and peroxynitrites. In this review, we examine the synthesis, metabolism and functional interactions of glutathione, and discuss how this relates to protection of dopaminergic neurons from oxidative damage and its therapeutic potential in Parkinson's disease.
Free Radical Biology and Medicine 05/2013; 62. DOI:10.1016/j.freeradbiomed.2013.05.001 · 5.74 Impact Factor
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