Abnormalities of brain structure can be investigated using more delicate and updated technologies such as voxel-based morphometry (VBM) in group analyses. Until now, it has been widely accepted that brain MRIs of individuals with idiopathic narcolepsy are normal by routine visual inspection. Another study, however, could not reproduce this finding. Keywords: Cataplexy Gray matter Magnetic resonance imaging Narcolepsy White matterÄecades ago, the first published neuroimaging paper reported an abnormality of the pontine reticular formation, where REM sleep is generated, in the brain MRIs of three idiopathic tic patients. Thus, structural neuroimaging may help clarify the underlying mechanism of certain phenotypes of narcolepsy syndrome. Longitudinal MRI data have suggested progression in narcolepsy, showing progressive corticalthinning in disease, and that such progression may become fasterin the case of patients with earlier disease onset. Numerous studies, exploring gray matter and white matter, showed distinct aspects of disease and symptoms in narcolepsy with cataplexy related to the hypothalamus, thalamus, amygdalo-hippocampus, and frontoparietal cortex. Brain magnetic resonance imaging (MRI) studies, in particular, demonstrated distinct structural changes in multiple brain areas of patients with narcolepsy. Developments in neuroimaging techniques have advanced the understanding and characterization of the pathophysiology of this disease. Narcolepsy is a chronic neurological disorder associated with abnormal regulation of the sleep-wake cycle, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and rapid eye movement (REM) sleep phenomena including cataplexy.
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