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Article

The Sustained Attention to Response Task Shows Lower Cingulo-Opercular and Frontoparietal Activity in People with Narcolepsy Type 1: An fMRI Study on the Neural Regulation of Attention

1
Department of Anatomy and Neurosciences, Amsterdam UMC, Location VUmc, De Boelelaan 1108, 1081HZ Amsterdam, Noord-Holland, The Netherlands
2
Sleep-Wake Centre SEIN, Achterweg 2, 2103SW Heemstede, Noord-Holland, The Netherlands
3
Department of Neurology, Leiden University Medical Centre, Albinusdreef 2, 2333ZA Leiden, The Netherlands
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(7), 419; https://doi.org/10.3390/brainsci10070419
Received: 19 May 2020 / Revised: 25 June 2020 / Accepted: 29 June 2020 / Published: 1 July 2020
(This article belongs to the Special Issue Effects of Sleep Disruption on Daytime Functioning)
Vigilance complaints often occur in people with narcolepsy type 1 and severely impair effective daytime functioning. We tested the feasibility of a three-level sustained attention to response task (SART) paradigm within a magnetic resonance imaging (MRI) environment to understand brain architecture underlying vigilance regulation in individuals with narcolepsy type 1. Twelve medication-free people with narcolepsy type 1 and 11 matched controls were included. The SART included four repetitions of a baseline block and two difficulty levels requiring moderate and high vigilance. Outcome measures were between and within-group performance indices on error rates and reaction times, and functional MRI (fMRI) parameters: mean activity during the task and between-group activity differences across the three conditions and related to changes in activation over time (time-on-task) and error-related activity. Patients—but not controls—made significantly more mistakes with increasing difficulty. The modified SART is a feasible MRI vigilance task showing similar task-positive brain activity in both groups within the cingulo-opercular, frontoparietal, arousal, motor, and visual networks. During blocks of higher vigilance demand, patients had significantly lower activation in these regions than controls. Patients had lower error-related activity in the left pre- and postcentral gyrus. The time-on-task activity differences between groups suggest that those with narcolepsy are insufficiently capable of activating attention- and arousal-related regions when transitioning from attention initiation to stable attention, specifically when vigilance demand is high. They also show lower inhibitory motor activity in relation to errors, suggesting impaired executive functioning. View Full-Text
Keywords: disorders of excessive somnolence; narcolepsy; hypocretin; magnetic resonance imaging; sustained attention to response task; vigilance disorders of excessive somnolence; narcolepsy; hypocretin; magnetic resonance imaging; sustained attention to response task; vigilance
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MDPI and ACS Style

Gool, J.K.; van der Werf, Y.D.; Lammers, G.J.; Fronczek, R. The Sustained Attention to Response Task Shows Lower Cingulo-Opercular and Frontoparietal Activity in People with Narcolepsy Type 1: An fMRI Study on the Neural Regulation of Attention. Brain Sci. 2020, 10, 419. https://doi.org/10.3390/brainsci10070419

AMA Style

Gool JK, van der Werf YD, Lammers GJ, Fronczek R. The Sustained Attention to Response Task Shows Lower Cingulo-Opercular and Frontoparietal Activity in People with Narcolepsy Type 1: An fMRI Study on the Neural Regulation of Attention. Brain Sciences. 2020; 10(7):419. https://doi.org/10.3390/brainsci10070419

Chicago/Turabian Style

Gool, Jari K., Ysbrand D. van der Werf, Gert J. Lammers, and Rolf Fronczek. 2020. "The Sustained Attention to Response Task Shows Lower Cingulo-Opercular and Frontoparietal Activity in People with Narcolepsy Type 1: An fMRI Study on the Neural Regulation of Attention" Brain Sciences 10, no. 7: 419. https://doi.org/10.3390/brainsci10070419

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