RESUMEN
Objective:To investigate the abnormal changes of the nodal centrality of the whole-brain network in patients with narcolepsy type 1 (NT1) through the degree centrality (DC) technique of resting-state magnetic resonance and the predictive value for NT1.Methods:From September 2019 to November 2021, 18 NT1 patients who were first diagnosed and never accepted managements and 18 age-, sex-matched healthy controls recruited by advertisement in the Second Affiliated Hospital of Nanchang University were required for resting-state functional magnetic resonance imaging scans and clinical scale assessment, including Epworth Sleepiness Scale (ESS), Self-rating Anxiety Scale, Self-rating Depression Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Scale and Multidimensional Fatigue Inventory-20 (MFI-20). The differences in DC values between the NT1 patients and healthy controls were analyzed using the DC method. Then, the correlation between DC values in differential brain regions and clinical characteristics of NT1 was explored through Pearson correlation analysis. The receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the DC values in the differential brain regions for NT1 patients.Results:Compared with the healthy controls, the DC value of the right superior temporal gyrus was increased, while the DC values of the bilateral middle frontal gyrus and the right precuneus were decreased in the NT1 patients (all P<0.05, Gaussian random-field correction). The DC value of the right superior temporal gyrus in the NT1 patients was positively correlated with the ESS score ( r=0.82, P<0.001) and MFI-20 score ( r=0.48, P=0.040). The DC value of the right middle frontal gyrus was positively correlated with the disease course ( r=0.51, P=0.032). The ROC curve showed that the area under the curve of NT1 predicted by the DC value of the right superior temporal gyrus was 0.95. And the areas under the curve of non-NT1 predicted by the DC values of the left middle frontal gyrus, right middle frontal gyrus, and right precuneus were 0.86, 0.84 and 0.87, respectively. Conclusions:NT1 patients have abnormal resting-state DC in the default network, executive network core brain regions, and superior temporal gyrus. And the DC value in the right superior temporal gyrus may be a potential biomarker of NT1 patients.
RESUMEN
La investigación sobre la conciencia desde una perspectiva neurobiológica constituye uno de los temas más controvertidos en el amplio dominio de las neurociencias. Tradicionalmente, la conciencia ha sido entendida como la experiencia subjetiva y privada que surge de la actividad de neuronas múltiples y que incluye nuestros pensamientos, recuerdos y lo imaginado. A menudo se hace la distinción entre una conciencia intransitiva, que alude a un estado de vigilancia opuesto al estado de coma clínico, y una transitiva, que se refiere al acceso consciente de diferentes piezas de información. Evolutivamente, al entender la conciencia como el resultado de habilidades cognitivas complejas, es posible plantear que ella se encuentra distribuida en la filogenia incluso más allá de los mamíferos sociales. A partir de la relación entre conciencia y cognición, dos teorías han sido ampliamente difundidas y debatidas: la del núcleo dinámico y la del espacio de trabajo global. La primera relaciona la experiencia consciente con circuitos tálamo-corticales recurrentes, mientras que la segunda considera vastas redes neuronales parieto-temporales y prefrontales como base para el acceso consciente. Se ha postulado que la conciencia depende de la actividad de una red neural por defecto. Aún más, la conciencia humana representaría una corriente narrativa cuya historia ha sido modulada por la interacción social.
Research about consciousness from a neurobiological perspective is one of the most controversial issues in the broad domain of neuroscience. Traditionally, consciousness has been defined as subjective and private experience that arises from multiple neuronal activities and it includes our thoughts, memories and imaging. Usually, it has been made a distinction between intransitive consciousness that refers to a vigilance state opposite to clinical coma and transitive consciousness conceived as a conscious access to different pieces of information. From an evolutionary perspective, consciousness may be conceived as the result of complex cognitive skills leading to claim that it is distributed in phylogeny even beyond social mammals. From the relationship between consciousness and cognition, two theories have been widely discussed: the Dynamic Core and the Global Workspace. The first relates conscious experience to recurrent thalamo cortical circuits, while the second considers parietotemporal and prefrontal large neural networks as the basis for conscious access. It has been suggested that human consciousness depends on a default network. Furthermore, human consciousness could represent a narrative stream of reflective thought that is critical for the control of actions and is encultured by social interaction.