A preliminary study investigating the clinical potential of measuring cerebrospinal-fluid lactate levels in patients with narcolepsy type 1 and 2
Abstract
STUDY OBJECTIVES
Besides the quantification of orexin-A/hypocretin-1 cerebrospinal fluid (CSF) levels in narcolepsy for diagnostic purposes, several other CSF biomarkers have been evaluated, although with controversial results. Since CSF lactate concentrations fluctuate according to the sleep-wake cycle with higher levels during wakefulness and lower levels during sleep, as documented in animal model studies, the present study aimed at quantifying the CSF lactate levels in patients with narcolepsy type 1 (NT1) and 2 (NT2), two sleep disorders featured by excessive daytime sleepiness (EDS).
METHODS
Patients with NT1 and NT2 were enrolled in this study and compared to a control group of similar age and sex. All the subjects included in the study underwent a polysomnographic study followed by lumbar puncture for the quantification of CSF lactate levels at awakening.
RESULTS
23 NT1 (43.5% male; 36.43 ± 11.89 years) and 15 NT2 patients (46.7% male; 37.8 ± 14.1 years) were compared to 17 controls (58.8% male; 32.3 ± 8.4 years). CSF lactate concentrations were reduced in patients with NT1 and NT2 compared to controls but no differences were found between the two groups of patients. ROC curves analysis showed that CSF lactate ≤1.3 mmol/l had a sensitivity of 96.49 and a specificity of 82.35% for discriminating patients with narcolepsy from controls.
CONCLUSIONS
The present study showed a decrease in CSF lactate levels in patients with narcolepsy. Notably, the reduction of lactate…
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