title: Dysautonomia in narcolepsy: evidence by questionnaire assessment.
abstract: OBJECTIVE
  Excessive daytime sleepiness and sudden sleep attacks are the main features of narcolepsy, but rapid-eye-movement sleep behavior disorder (RBD), hyposmia, and depression can also occur. The latter symptoms are nonmotor features in idiopathic Parkinson's disease (IPD). In the present study, IPD-proven diagnostic tools were tested to determine whether they are also applicable in the assessment of narcolepsy.
  
  
  METHODS
  This was a case-control study comparing 15 patients with narcolepsy (PN) and 15 control subjects (CS) using the Scales for Outcomes in Parkinson's Autonomic Test (SCOPA-AUT), Parkinson's Disease Nonmotor Symptoms (PDNMS), University of Pennsylvania Smell Test, Farnsworth-Munsell 100 Hue test, Beck Depression Inventory, and the RBD screening questionnaire.
  
  
  RESULTS
  Both the PN and CS exhibited mild hyposmia and no deficits in visual tests. Frequent dysautonomia in all domains except sexuality was found for the PN. The total SCOPA-AUT score was higher for the PN (18.47±10.08, mean±SD) than for the CS (4.40±3.09), as was the PDNMS score (10.53±4.78 and 1.80±2.31, respectively). RBD was present in 87% of the PN and 0% of the CS. The PN were more depressed than the CS. The differences between the PN and CS for all of these variables were statistically significant (all p<0.05).
  
  
  CONCLUSIONS
  The results of this study provide evidence for the presence of dysautonomia and confirm the comorbidities of depression and RBD in narcolepsy patients. The spectrum, which is comparable to the nonmotor complex in IPD, suggests wide-ranging, clinically detectable dysfunction beyond the narcoleptic core syndrome.
authors.affiliation: Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg. ; Department of Internal Medicine, Brothers of Charity Hospital, Trier, Germany.
authors.forename: Gilles
authors.initials: G
authors.lastname: Klein
authors.affiliation: Department of Neurology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Burghaus
authors.affiliation: Competences Center for Methodology and Statistics, CRP Santé, Strassen, Luxembourg.
authors.forename: Michel
authors.initials: M
authors.lastname: Vaillant
authors.affiliation: Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg.
authors.forename: Vannina
authors.initials: V
authors.lastname: Pieri
authors.affiliation: Department of Neurology, University Hospital of Cologne, Cologne, Germany. ; Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Research Centre Juelich, Juelich, Germany.
authors.forename: Gereon R
authors.initials: GR
authors.lastname: Fink
authors.affiliation: Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg. ; Department of Neurology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Diederich
keywords: Parkinson's disease; autonomic failure; multisystem disorder; narcolepsy