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Open AccessFeature PaperArticle

Neuropeptides’ Hypothalamic Regulation of Sleep Control in Children Affected by Functional Non-Retentive Fecal Incontinence

1
Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetic and Sport Medicine, University of Campania “Luigi Vanvitelli”, 81100 Caserta CE, Italy
2
Sleep Lab for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 81100 Caserta CE, Italy
3
Neurodevelopmental Research Lab, Biomedical Research Institute of New Jersey (BRInj), Morristown, NJ 07960, USA
4
Neuroscience Research, MidAtlantic Neonatology Associates (MANA), Atlantic Health System (AHS), Morristown, NJ 07927, USA
5
Neuropathology Research, MANA-BRInj, Cedar Knolls, NJ 07927, USA
6
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia FG, Italy
7
Department of Psychology, Educational and Science and Human Movement, University of Palermo, 90133 Palermo PA, Italy
8
Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro,” University of Palermo, 90133 Palermo PA, Italy
9
Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano SA, Italy
10
Department of Woman, Child and General and Specialistc Surgery, University of Campania, “Luigi Vanvitelli”, 81100 Caserta CE, Italy
11
Anatomy Department, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Brain Sci. 2020, 10(3), 129; https://doi.org/10.3390/brainsci10030129
Received: 16 November 2019 / Revised: 21 February 2020 / Accepted: 24 February 2020 / Published: 25 February 2020
(This article belongs to the Special Issue Recent Advances in Neurodevelopmental Disorders)
Functional non-retentive fecal incontinence (FNRFI) is a common problem in pediatric age. FNRFI is defined as unintended loss of stool in a 4-year-old or older child after organic causes have been excluded. FNRFI tends to affects up to 3% of children older than 4 years, with males being affected more frequently than females. Clinically, children affected by FNRFI have normal intestinal movements and stool consistency. Literature data show that children with fecal incontinence have increased levels of separation anxiety, specific phobias, general anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder. In terms of possible relationship between incontinence and sleep, disorders of sleep organization have been observed in the pathogenesis of enuresis so generating the hypothesis that the orexinergic system may have a crucial role not only for the sleep organization per se but also for the sphincterial control in general. This study aimed to focus on specific neurophysiological aspects to investigate on the possible relationship between sleep organizational abnormalities and FNRFI. Specifically, we aimed to measure orexin serum levels in children with FNRFI and assess their polysomnographic sleep macrostructure patterns. Two study groups were considered: FNFRI (n = 45) and typically developed (TD) (n = 45) group. In both groups, sleep patterns and respiratory events were assessed by polysomnographic recordings (PSG) during a period of two nights at least, and plasma levels of Orexin-A were measured in each participant. The findings of this initial investigation seem to support a major role of Orexin-A in sleep organization alterations in children with FNFRI. Also, our data suggest that sleep habits evaluation should be considered as screening and complementary tool for the diagnosis of fecal incontinence in children. View Full-Text
Keywords: functional non-retentive fecal incontinence (FNRFI); polysomnographic (PSG) assessment; orexin-A; sleep organization disorders functional non-retentive fecal incontinence (FNRFI); polysomnographic (PSG) assessment; orexin-A; sleep organization disorders
MDPI and ACS Style

Monda, V.; Carotenuto, M.; Precenzano, F.; Iacono, D.; Messina, A.; Salerno, M.; Sessa, F.; Lanzara, V.; Messina, G.; Quatrosi, G.; Nardello, R.; Operto, F.F.; Santoro, C.; Moscatelli, F.; Porro, C.; Zammit, C.; Monda, M.; Pastorino, G.M.G.; Vetri, L.; Parisi, L.; Ruberto, M.; Roccella, M. Neuropeptides’ Hypothalamic Regulation of Sleep Control in Children Affected by Functional Non-Retentive Fecal Incontinence. Brain Sci. 2020, 10, 129.

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