NEUROBIOLOGICAL, GENETIC AND IMMUNOLOGICAL ASPECTS OF NARCOLEPSY: INTEGRATIVE LITERATURE REVIEW

Abstract

Narcolepsy is a sleep disorder that causes physical, psychological and social damage which total or partial work or academic incapacity. Objectives: Present the main findings in the scientific literature about the neurobiological, immunological/genetic and diagnostic aspects of narclepsy. Method: Integrative literature review. The databases used in the search were: Scielo, Pubmed, LILACS and Science, basically using the descriptors “narcolepsy”, “orexin”, “cataplexy” and “neurobiology”, with the Boolean operator “and” or “or”. Results: We found 151 articles, and 23 were selected for analysis. The International Classification of Sleep Disorders (ICSD-3) differentiates narcolepsy into two pathologies, type 1 (NT1), is characterized by periods of irresistible need for sleep, cataplexy, and sometimes symptoms such as hypnagogic hallucinations, sleep paralysis and disturbed night sleep. It ischaracterized by the loss of hypocretin neurons in the hypothalamus, possibly linked to an autoimmune process. In NT2, cataplexy is absent and CSF hypocretin levels are normal. The etiopathogenesis and pathophysiology involve several genetic, immunological and hormonal aspects. Diagnosis is made with polysomnography, multiple sleep latency testing, human leukocyte antigen (HLA) typing, cerebrospinal fluid (CSF) hypocretin level, or neuroimaging in suspected narcolepsy secondary to another pathology. Conclusion: neurosciences and related ones have advanced in discoveries about the neurobiology and natural history of narcolepsy; however, new studies should relate it to other aspects, such as endocrinology