514 Narcocataplectic patients, psychiatric symptoms and executive functions: is there a link?

Abstract Introduction Narcolepsy with cataplexy (NC) is a neurological disorder characterized by orexin deficiency in the hypothalamus with associations to areas implied in emotion. Several studies highlighted a deficit in executive functions in narcoleptic patients. Moreover literature reports a wide comorbidity between NC and psychiatric disorders, but the relationships in NC patients are still unclear. The aim of our study is to evaluate possible mood and anxiety disorders in NC patients and understand their relationship with cognitive performances. Methods We assessed 15 NC patients with questionnaires concerning degree of somnolence [ESS], depression [BDI-II], perceived stress [PSS], state and trait anxiety [STAY-Y I and II]. Furthermore, patients performed a battery test (PEBL - psychology experiment building language) to investigate executive functions through 7 tests (Berg’s Card Sorting Test [BCST]; Tower of London [TOL]; Continuous Performance Task [CPT]; Go / No-go Task; Victoria Stroop Test [VST]; Balloon Analogue Risk Task [BART]; Digit Span Forward). Results Descriptive analyses show that NC subjects have pathological daytime sleepiness (16,07±2,94), moderate perceived stress (19,73±3,95), mild state anxiety (48,67±15,77). However, subjects do not show pathological indexes in depression and in trait anxiety. We also found a positive correlation in both state and trait anxiety with failure to maintain set in the BCST test (r=0,644; p=0,010 and r=0,573; p=0,025, respectively). However, no significant correlations were found between PEBL scores and excessive daytime sleepiness, depression, and perceived stress. Conclusion Our data confirm that NC subjects show symptoms related to stress and anxiety, that can facilitate the change of the set during cognitive performances. Since the neurotransmission of hypocretin is involved in the regulation of stress and anxiety, it is important to understand whether these symptoms are primary pathological phenomena in NC patients. Our data suggest that sleep medicine experts should also consider psychiatric aspects during the cognitive assessment of NC patients. Support (if any) None