CSF hypocretin-1 levels are normal in patients with amyotrophiclateral sclerosis

摘要

Hypocretin (orexin) neurotransmission is not only crucially involved in the regulation of sleep and wake, but serves inmultiple autonomic and cognitive functions as well. This is reflected in the widespread connections between thehypothalamic hypocretin neurons and the rest of the brain, such as dense projections to the frontal cortex. Both frontalcognitive impairment and autonomic disturbances have been described in ALS. Furthermore, in some ALS patients theremay be sleep disturbances other than sleep related breathing disorders, including REM sleep behaviour disorder. Inaddition, a role for the hypocretin system in the regulation of motor functions has been suggested. Hypocretin defects havebeen described in several neurodegenerative disorders. We therefore speculated that the hypocretin system is also involved inALS and measured hypocretin-1 levels in cerebrospinal fluid samples from 20 patients. All results were well within thenormal range (>200 pg/ml) and individual values showed no correlation with age, gender and disease duration. Weconclude that it is unlikely that the hypocretin system is involved in the degenerative process of ALS.