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Objective: To assesses the prevalence and co-occurrence of anxiety, depressive symptoms, suicidal thoughts, and hopelessness in patients with narcolepsy type 1 (NT1)., Patients/methods: In this cross-sectional study, 127 patients with NT1 (mean age 38.2 ± 15.5 years, 53.5 % female) and 131 controls (mean age 37.4 ± 14.3 years, 59.5 % female) matched for age, sex, and education, filled in the following validated questionnaires: Beck Depression Inventory-II (BDI), State-Trait Anxiety Inventory (STAI), and Beck Hopelessness Scale (BHS). Comparisons between groups and multivariable logistic regression analyses were performed., Results: Patients with NT1 presented significantly higher scores in BDI, suicidal thoughts (BDI-item-9), STAI-trait, STAI-state, and BHS than controls. Adjusted for age, sex, and educational level, NT1 was significantly associated with depressive symptoms (BDI≥13; OR 3.23, 95%CI 1.71-6.10), trait anxiety symptoms (STAI-trait≥38; OR 1.91, 95%CI 1.14-3.21), co-occurrence of BDI≥13 with STAI-trait≥38 (OR 2.72, 95%CI 1.47-5.05), and with STAI-state≥38 (OR 2.24, 95%CI 1.17-4.30), and moderate to severe hopelessness (BHS≥9; OR 2.95, 95%CI 1.55-5.63)., Conclusions: Patients with NT1 present a multidimensional psychiatric burden and comorbidity between symptoms of depression and anxiety and suicidal thoughts, a concern that deserves tailored interventions., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Giuseppe Plazzi reports a relationship with Jazz Pharmaceuticals that includes: board membership. Giuseppe Plazzi reports a relationship with Bioprojet that includes: board membership. Giuseppe Plazzi reports a relationship with Centessa Pharmaceuticals, LLC that includes: board membership. Giuseppe Plazzi reports a relationship with Takeda Pharmaceutical Company Limited that includes: board membership. Giuseppe Plazzi reports a relationship with Idorsia Pharmaceuticals Ltd that includes: board membership. Fabio Pizza reports a relationship with Takeda Pharmaceutical Company Limited that includes: consulting or advisory. Fabio Pizza reports a relationship with Jazz Pharmaceuticals Inc that includes: speaking and lecture fees. Fabio Pizza reports a relationship with Bioprojet that includes: travel reimbursement. Elena Antelmi reports a relationship with Bioprojet that includes: speaking and lecture fees and travel reimbursement. Elena Antelmi reports a relationship with Jazz Pharmaceuticals Inc that includes: speaking and lecture fees and travel reimbursement. Elena Antelmi reports a relationship with Polifarma that includes: speaking and lecture fees. Francesco Biscarini reports a relationship with Bioprojet that includes: travel reimbursement. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To investigate adolescents' and parents' preferences concerning information on narcolepsy., Methods: During a one-year cross-sectional study, adolescents (12-20 years old) with narcolepsy and parents attending the Narcolepsy Center of Bologna (Italy) were invited to fill in a questionnaire including 28 pieces of information regarding narcolepsy, 14 concerning medical issues (i.e., diagnosis, prognosis, treatment, management) and 14 concerning psychosocial issues (i.e., impact on everyday life, relationships, possible support). Participants were asked to indicate: the importance of each item on a 5-point Likert scale; when each piece of information should be provided (diagnostic suspicion, confirmed diagnosis, follow-up visits, upon patient's request); and who should provide it (doctor, nurse, psychologist, parents and/or others)., Results: Sixty-two adolescents (37% female, mean age 16.4 years) and 96 parents (58% female, mean age 48.2 years) agreed to participate (100% response rate). Parents rated all items as important (score≥4), while, according to adolescents, 11/14 medical and psychosocial issues were important. The moment of diagnosis was considered the right time to give almost all medical information. Regarding psychosocial issues, mothers mainly indicated the time of diagnosis, while fathers also indicated follow-up visits, and some children opted for follow-up visits or information upon request. The doctor was the preferred provider but when information concerned psychosocial issues, adolescents also indicated the parents, and parents also indicated the psychologist., Conclusions: This study suggests that information on narcolepsy should be comprehensive and tailored, and that parents and psychologists may support the doctor in providing information when narcolepsy is diagnosed during adolescence., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (ADQ) as a new diagnostic tool for DoA diagnosis. The objective of this study was to evaluate the diagnostic accuracy of the ADQ in a sleep and epilepsy center., Methods: One interviewer blinded to clinical and video-polysomnographic (VPSG) data administered the ADQ to 150 patients consecutively admitted to our Sleep and Epilepsy Centers for a follow-up visit. The final diagnosis, according to VPSG recordings of at least one major episode, classified patients either with DoA (DoA group) or with other sleep-related motor behaviors confounding for DoA (nDoA group)., Results: 47 patients (31%) composed the DoA group; 56 patients with REM sleep behavior disorder, 39 with sleep-hypermotor epilepsy, six with night eating syndrome, and two with drug-induced DoA composed the nDoA group. The ADQ had a sensitivity of 72% (95% CI: 60-82) and a specificity of 96% (95% CI: 89-98) for DoA diagnosis; excluding the items regarding consciousness and episode recall, sensitivity was 83% (95% CI: 71-90) and specificity 93% (95% CI: 86-97)., Conclusions: The ADQ showed good accuracy in screening patients with DoA in a sleep and epilepsy center setting. Diagnostic criteria related to cognition and episode recall reduced ADQ sensitivity, therefore a better definition of these criteria is required, especially in adults., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: The aim of this study was to characterize the neuropsychological features of a representative sample of Sleep-related Hypermotor Epilepsy (SHE) patients and to highlight clinical associations., Methods: This cross-sectional study included 60 consecutive patients with video/video-electroencephalography-documented SHE. All were assessed by measures of intelligence. Individuals with normal scores underwent a standardized battery of tests. The Fisher exact test and Wilcoxon rank-sum test for statistical analysis., Results: Mean total IQ was 96.96 ± 21.50, with significant differences between verbal and performance scores (p < 0.0001). Nine patients (15%) had intellectual disability (ID)/cognitive deterioration. Of the 49 assessed by the extensive battery, 23 (46.9%) showed deficits in at least one test evaluating phonemic fluency (24.5%), memory (24.5%), inhibitory control (22.4%), or working memory (10.2%). Patients with mutations in SHE genes had lower IQ than patients without mutations, irrespective of the specific gene (p = 0.0176). Similarly, pathological neurological examination (NE) and "any underlying brain disorder" (at least one among pathological NE, abnormal brain magnetic resonance imaging findings, perinatal insult) were associated with ID (p = 0.029, p = 0.036). A higher seizure frequency at last assessment and poor prognosis correlated with worse scores in visuo-spatial memory (p = 0.038, p = 0.040) and visuo-spatial abilities (p = 0.016). Status epilepticus (p = 0.035), poor response to antiepileptic drugs (p = 0.033), and poor prognosis (p = 0.020) correlated with lower shifting abilities, whereas bilateral convulsive seizures correlated with worse working memory (p = 0.049)., Conclusion: In all, 53.3% of SHE patients had neuropsychological deficits. The profile of impairment showed worse verbal IQ, as well as deficits in extrafrontal and selective frontal functions. Our data support the contribution of genetics in ID by different biological mechanisms. Variables of clinical severity affect memory and executive functioning., (Copyright © 2018 Elsevier B.V. All rights reserved.)