The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias
Abstract
CONTEXT: Narcolepsy, a neurological disorder affecting 1 in 2000 individuals, is associated with HLA-DQB1*0602 and low cerebrospinal fluid (CSF) hypocretin (orexin) levels. OBJECTIVES: To delineate the spectrum of the hypocretin deficiency syndrome and to establish CSF hypocretin-1 measurements as a diagnostic tool for narcolepsy. DESIGN: Diagnosis, HLA-DQ, clinical data, the multiple sleep latency test (MSLT), and CSF hypocretin-1 were studied in a case series of patients with sleep disorders from 1999 to 2002. Signal detection analysis was used to determine the CSF hypocretin-1 levels best predictive for International Classification of Sleep Disorders (ICSD)-defined narcolepsy (blinded criterion standard). Clinical and demographic features were compared in narcoleptic subjects with and without low CSF hypocretin-1 levels. SETTING: Sleep disorder and neurology clinics in the United States and Europe, with biological testing performed at Stanford University, Stanford, Calif. PARTICIPANTS: There were 274 patients with narcolepsy; hypersomnia; obstructive sleep apnea; restless legs syndrome; insomnia; and atypical hypersomnia cases such as familial cases, narcolepsy without cataplexy or without HLA-DQB1*0602, recurrent hypersomnias, and symptomatic cases (eg, Parkinson disease, depression, Prader-Willi syndrome, Niemann-Pick disease type C). The subject group also included 296 controls (healthy and with neurological disorders). INTERVENTION: Venopuncture for HLA typing, lumbar puncture for CSF analysis, primary diagnosis using the International Classification of Sleep Disorders, Stanford Sleep Inventory for evaluation of narcolepsy, and sleep recording studies. MAIN OUTCOME MEASURES: Diagnostic threshold for CSF hypocretin-1, HLA-DQB1*0602 positivity, and clinical and polysomnographic features. RESULTS: HLA-DQB1*0602 frequency was increased in narcolepsy with typical cataplexy (93% vs 17% in controls), narcolepsy without cataplexy (56%), and in essential hypersomnia (52%). Hypocretin-1 levels below 110 pg/mL were diagnostic for narcolepsy. Values above 200 pg/mL were considered normal. Most subjects with low levels were HLA-DQB1*0602-positive narcolepsy-cataplexy patients. These patients did not always have abnormal MSLT. Rare subjects without cataplexy, DQB1*0602, and/or with secondary narcolepsy had low levels. Ten subjects with hypersomnia had intermediate levels, 7 with narcolepsy (often HLA negative, of secondary nature, and/or with atypical cataplexy or no cataplexy), and 1 with periodic hypersomnia. Healthy controls and subjects with other sleep disorders all had normal levels. Neurological subjects had generally normal levels (n = 194). Intermediate (n = 30) and low (n = 3) levels were observed in various acute neuropathologic conditions. CONCLUSIONS: Narcolepsy-cataplexy with hypocretin deficiency is a genuine disease entity. Measuring CSF hypocretin-1 is a definitive diagnostic test, provided that it is interpreted within the clinical context. It may be most useful in cases with cataplexy and when the MSLT is difficult to interpret (ie, in subjects already treated with psychoactive drugs or with other concurrent sleep disorders).
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
Sakurai, T., Amemiya, A., Ishii, M., Matsuzaki, I., Chemelli, R. M., Tanaka, H., Williams, S. C., Richardson, J. A., Kozlowski, G. P., Wilson, S., et al. (1998) · Cell · doi:10.1016/s0092-8674(00)80949-6 · Cited by 5,501 · see citing works
The International Classification of Sleep Disorders
Daroff, R. B. (1991) · Neurology · doi:10.1212/wnl.41.1.160 · Cited by 5,025 · see citing works
The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity
de Lecea, L., Kilduff, T. S., Peyron, C., Gao, X.-B., Foye, P. E., Danielson, P. E., Fukuhara, C., Battenberg, E. L. F., Gautvik, V. T., Bartlett, F. S., et al. (1998) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.95.1.322 · Cited by 3,878 · see citing works
Neurons containing hypocretin (orexin) project to multiple neuronal systems
Peyron, C., Tighe, D. K., van den Pol, A. N., de Lecea, L., Heller, H. C., Sutcliffe, J. G., & Kilduff, T. S. (1998) · The Journal of Neuroscience · doi:10.1523/jneurosci.18-23-09996.1998 · Cited by 3,466 · see citing works
Narcolepsy in orexin Knockout Mice
Chemelli, R. M., Willie, J. T., Sinton, C. M., Elmquist, J. K., Scammell, T., Lee, C., Richardson, J. A., Williams, S. C., Xiong, Y., Kisanuki, Y., et al. (1999) · Cell · doi:10.1016/s0092-8674(00)81973-x · Cited by 3,095 · see citing works
Lin, L., Faraco, J., Li, R., Kadotani, H., Rogers, W., Lin, X., Qiu, X., de Jong, P. J., Nishino, S., & Mignot, E. (1999) · Cell · doi:10.1016/s0092-8674(00)81965-0 · Cited by 2,613 · see citing works
Self-citationPeyron, C., Faraco, J., Rogers, W., Ripley, B., Overeem, S., Charnay, Y., Nevsimalova, S., Aldrich, M., Reynolds, D., Albin, R., et al. (2000) · Nature Medicine · doi:10.1038/79690 · Cited by 2,118 · see citing works
Self-citationReduced Number of Hypocretin Neurons in Human Narcolepsy
Thannickal, T. C., Moore, R. Y., Nienhuis, R., Ramanathan, L., Gulyani, S., Aldrich, M., Cornford, M., & Siegel, J. M. (2000) · Neuron · doi:10.1016/s0896-6273(00)00058-1 · Cited by 2,089 · see citing works
Hypocretin (orexin) deficiency in human narcolepsy
Nishino, S., Ripley, B., Overeem, S., Lammers, G. J., & Mignot, E. (2000) · The Lancet · doi:10.1016/s0140-6736(99)05582-8 · Cited by 1,776 · see citing works
Self-citationGuidelines for the Multiple Sleep Latency Test (MSLT): A Standard Measure of Sleepiness
Carskadon, M. A. (1986) · SLEEP · doi:10.1093/sleep/9.4.519 · Cited by 1,607 · see citing works
Genetic Ablation of Orexin Neurons in Mice Results in Narcolepsy, Hypophagia, and Obesity
Hara, J., Beuckmann, C. T., Nambu, T., Willie, J. T., Chemelli, R. M., Sinton, C. M., Sugiyama, F., Yagami, K.-I., Goto, K., Yanagisawa, M., et al. (2001) · Neuron · doi:10.1016/s0896-6273(01)00293-8 · Cited by 1,401 · see citing works
Toward a better definition of the restless legs syndrome
Walters, A. S., Aldrich, M. S., Allen, R., Ancoli‐Israel, S., Buchholz, D., Chokroverty, S., Coccagna, G., Earley, C., Ehrenberg, B., Feest, T. G., et al. (1995) · Movement Disorders · doi:10.1002/mds.870100517 · Cited by 1,100 · see citing works
To Eat or to Sleep? Orexin in the Regulation of Feeding and Wakefulness
Willie, J. T., Chemelli, R. M., Sinton, C. M., & Yanagisawa, M. (2001) · Annual Review of Neuroscience · doi:10.1146/annurev.neuro.24.1.429 · Cited by 768 · see citing works
SLEEP AS A PROBLEM OF LOCALIZATION
von Economo, C. (1930) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-193003000-00001 · Cited by 687 · see citing works
Evaluating Medical Tests: Objective and Quantitative Guidelines.
Guthrie, D., & Kraemer, H. C. (1992) · Journal of the American Statistical Association · doi:10.2307/2290671 · Cited by 636 · see citing works
Complex HLA-DR and -DQ Interactions Confer Risk of Narcolepsy-Cataplexy in Three Ethnic Groups
Mignot, E., Lin, L., Rogers, W., Honda, Y., Qiu, X., Lin, X., Okun, M., Hohjoh, H., Miki, T., Hsu, S. H., et al. (2001) · The American Journal of Human Genetics · doi:10.1086/318799 · Cited by 594 · see citing works
Self-citationGenetic and familial aspects of narcolepsy
Mignot, E. J.-M. (1998) · Neurology · doi:10.1212/wnl.50.2_suppl_1.s16 · Cited by 590 · see citing works
Self-citationCassidy, S. B. (1997) · Journal of Medical Genetics · doi:10.1136/jmg.34.11.917 · Cited by 472 · see citing works
Low cerebrospinal fluid hypocretin (orexin) and altered energy homeostasis in human narcolepsy
Nishino, S., Ripley, B. A., Overeem, S., Nevšímalová, S., Lammers, G. J., Vaňková, J., Okun, M. L., Rogers, W. M., Brooks, S. N., & Mignot, E. J.-M. (2001) · Annals of Neurology · doi:10.1002/ana.1130 · Cited by 451 · see citing works
Self-citationPHARMACOLOGICAL ASPECTS OF HUMAN AND CANINE NARCOLEPSY
Nishino, S., & Mignot, E. J.-M. (1997) · Progress in Neurobiology · doi:10.1016/s0301-0082(96)00070-6 · Cited by 449 · see citing works
Self-citationThe hypocretin/orexin ligand–receptor system: implications for sleep and sleep disorders
Kilduff, T. S., & Peyron, C. (2000) · Trends in Neurosciences · doi:10.1016/s0166-2236(00)01594-0 · Cited by 438 · see citing works
CSF hypocretin/orexin levels in narcolepsy and other neurological conditions
Ripley, B., Overeem, S., Fujiki, N., Nevsimalova, S., Uchino, M., Yesavage, J., Di Monte, D., Dohi, K., Melberg, A., Lammers, G. J., et al. (2001) · Neurology · doi:10.1212/wnl.57.12.2253 · Cited by 415 · see citing works
Self-citationHLA DQB1*0602 is Associated With Cataplexy in 509 Narcoleptic Patients
Mignot, E. J.-M., Hayduk, R., Black, J. E., Grumet, F. C., & Guilleminault, C. (1997) · SLEEP · doi:10.1093/sleep/20.11.1012 · Cited by 394 · see citing works
Self-citationHLA antigens in Japanese patients with narcolepsy
Juji, T., Satake, M., Honda, Y., & Doi, Y. (1984) · Tissue Antigens · doi:10.1111/j.1399-0039.1984.tb02144.x · Cited by 373 · see citing works
Increased body-mass index in patients with narcolepsy
Schuld, A., Hebebrand, J., Geller, F., & Pollmächer, T. (2000) · The Lancet · doi:10.1016/s0140-6736(05)74704-8 · Cited by 331 · see citing works
Narcolepsy:Clinical Features, New Pathophysiologic Insights, and Future Perspectives
Overeem, S., Mignot, E. J.-M., GertvanDijk, J., & Lammers, G. J. (2001) · Journal of Clinical Neurophysiology · doi:10.1097/00004691-200103000-00002 · Cited by 327 · see citing works
Self-citationIdiopathic hypersomnia. A series of 42 patients
Bassetti, C. L. (1997) · Brain · doi:10.1093/brain/120.8.1423 · Cited by 306 · see citing works
Self-citationValue of the Multiple Sleep Latency Test (MSLT) for the Diagnosis of Narcolepsy
Aldrich, M. S., Chervin, R. D., & Malow, B. A. (1997) · SLEEP · doi:10.1093/sleep/20.8.620 · Cited by 262 · see citing works
Hypnagogic and Hypnopompic Hallucinations: Pathological Phenomena?
Ohayon, M. M., Priest, R. G., Caulet, M., & Guilleminault, C. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.169.4.459 · Cited by 248 · see citing works
Validation of a Cataplexy Questionnaire in 983 Sleep-disorders Patients
Anic-Labat, S., Guilleminault, C., KRAEMER, H. C., Meehan, J., Arrigoni, J., & Mignot, E. J.-M. (1999) · SLEEP · doi:10.1093/sleep/22.1.77 · Cited by 242 · see citing works
Self-citationThe prevalence of narcolepsy: An epidemiological study of the Finnish Twin Cohort
Hublin, C., Kaprio, J. A., Partinen, M., Koskenvuo, M. J., Heikkila, K. V., Koskimies, S., & Guilleminault, C. (1994) · Annals of Neurology · doi:10.1002/ana.410350612 · Cited by 214 · see citing works
Mignot, E. J.-M., Lin, X., Arrigoni, J., Macaubas, C., Olive, F. T., Hallmayer, J. F., Underhill, P. A., Guilleminault, C., Dement, W. C., & Grumet, F. C. (1994) · SLEEP · doi:10.1093/sleep/17.suppl_8.s60 · Cited by 202 · see citing works
Self-citationPrevalence and pathologic associations of sleep paralysis in the general population
Ohayon, M. M., Zulley, J., Guilleminault, C., & Smirne, S. (1999) · Neurology · doi:10.1212/wnl.52.6.1194 · Cited by 202 · see citing works
Kanbayashi, T., Inoue, Y., Chiba, S., et al. (2002) · Journal of Sleep Research · doi:10.1046/j.1365-2869.2002.00284.x · Cited by 197 · see citing works
Clinical Aspects of Narcolepsy-Cataplexy Across Ethnic Groups
Okun, M. L., Lin, L., Pelin, Z., Hong, S.-C., & Mignot, E. J.-M. (2002) · SLEEP · doi:10.1093/sleep/25.1.27 · Cited by 192 · see citing works
Self-citationGammahydroxybutyrate and Narcolepsy: A Double-Blind Placebo-Controlled Study
Lammers, G. J., Arends, J. B. A. M., Declerck, A. C., Ferrari, M. D., Schouwink, G., & Troost, J. (1993) · SLEEP · doi:10.1093/sleep/16.3.216 · Cited by 179 · see citing works
Self-citationQuantitative neuropathological changes in presymptomatic Huntington's disease
Gómez‐Tortosa, E., MacDonald, M. E., Friend, J. C., Taylor, S. A., Weiler, L., Cupples, L. A., Srinidhi, J., Gusella, J. F., Bird, E. D., Vonsattel, J., et al. (2001) · Annals of Neurology · doi:10.1002/1531-8249(200101)49:1 · Cited by 170 · see citing works
Challamel, M., Mazzola, M. E., Nevšímalová, S., Cannard, C., Louis, J., & Révol, M. (1994) · SLEEP · doi:10.1093/sleep/17.suppl_8.s17 · Cited by 166 · see citing works
Hypocretin/orexin, sleep and narcolepsy
Hungs, M., & Mignot, E. J.-M. (2001) · BioEssays · doi:10.1002/bies.1058 · Cited by 151 · see citing works
Self-citationIncreased Frequency of Non-Insulin-Dependent Diabetes Mellitus Among Narcoleptic Patients
Honda, Y., Doi, Y., Ninomiya, R., & Ninomiya, C. (1986) · SLEEP · doi:10.1093/sleep/9.1.254 · Cited by 150 · see citing works
Late-onset central hypoventilation with hypothalamic dysfunction: A distinct clinical syndrome
Katz, E. S., McGrath, S. A., & Marcus, C. L. (2000) · Pediatric Pulmonology · doi:10.1002/(sici)1099-0496(200001)29:1 · Cited by 142 · see citing works
Psychosocial Impact of Narcolepsy
Broughton, W. A., & Broughton, R. (1994) · SLEEP · doi:10.1093/sleep/17.suppl_8.s45 · Cited by 135 · see citing works
Narcolepsy and low CSF orexin (hypocretin) concentration after a diencephalic stroke
Scammell, T. E., Nishino, S., Mignot, E. J.-M., & Saper, C. B. (2001) · Neurology · doi:10.1212/wnl.56.12.1751 · Cited by 130 · see citing works
Self-citationIDIOPATHIC NARCOLEPSY: A DISEASE SUI GENERIS; WITH REMARKS ON THE MECHANISM OF SLEEP
Adie, W. J. (1926) · Brain · doi:10.1093/brain/49.3.257 · Cited by 130 · see citing works
Normal hypocretin-1 levels in Parkinson’s disease patients with excessive daytime sleepiness
Overeem, S., van Hilten, J. J., Ripley, B. A., Mignot, E. J.-M., Nishino, S., & Lammers, G. J. (2002) · Neurology · doi:10.1212/wnl.58.3.498 · Cited by 129 · see citing works
Self-citationManni, R., Politini, L., Nobili, L., Ferrillo, F., Livieri, C., Veneselli, E., Biancheri, R., Martinetti, M., & Tartara, A. (2001) · Clinical Neurophysiology · doi:10.1016/s1388-2457(01)00483-7 · Cited by 120 · see citing works
Posttraumatic excessive daytime sleepiness
Guilleminault, C., Faull, K. F., Miles, L. E. M., & den Hoed, J. V. (1983) · Neurology · doi:10.1212/wnl.33.12.1584 · Cited by 119 · see citing works
Posttraumatic Narcolepsy in Mild to Moderate Closed Head Injury
Lankford, D. A., Wellman, J. J., & O'Hara, C. (1994) · SLEEP · doi:10.1093/sleep/17.suppl_8.s25 · Cited by 116 · see citing works
The positive diagnosis of narcolepsy and narcolepsy's borderland
Moscovitch, A., Partinen, M., & Guilleminault, C. (1993) · Neurology · doi:10.1212/wnl.43.1_part_1.55 · Cited by 111 · see citing works
Mononucleosis and chronic daytime sleepiness. A long-term follow-up study
Guilleminault, C. (1986) · Archives of Internal Medicine · doi:10.1001/archinte.146.7.1333 · Cited by 89 · see citing works
Diagnostic aspects of narcolepsy
Aldrich, M. S. (1998) · Neurology · doi:10.1212/wnl.50.2_suppl_1.s2 · Cited by 87 · see citing works
(1991) · PubMed · Cited by 85 · see citing works
A Commentary on the Neurobiology of the Hypocretin/Orexin System
Mignot, E. J.-M. (2001) · Neuropsychopharmacology · doi:10.1016/s0893-133x(01)00316-5 · Cited by 82 · see citing works
Self-citationA hypersomnolent girl with decreased CSF hypocretin level after removal of a hypothalamic tumor
Arii, J., Kanbayashi, T., Tanabe, Y., et al. (2001) · Neurology · doi:10.1212/wnl.56.12.1775 · Cited by 78 · see citing works
Mayer, G., Leonhard, E., Krieg, J. C., et al. (1998) · SLEEP · doi:10.1093/sleep/21.3.278 · Cited by 70 · see citing works
Martin, A., State, M. W., Koenig, K. M., Schultz, R. T., Dykens, E., Cassidy, S. B., & Leckman, J. F. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.9.1265 · Cited by 68 · see citing works
A hundred years of narcolepsy research.
Mignot, E. (2001) · PubMed · Cited by 32 · see citing works
Self-citationKleine-Levin syndrome ethiopathogenesis and treatment.
Smolik, P., & Roth, B. (1988) · PubMed · Cited by 28 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
The neural circuit of orexin (hypocretin): maintaining sleep and wakefulness
Sakurai, T. (2007) · Nature Reviews Neuroscience · doi:10.1038/nrn2092 · Cited by 1,276 · see citing works
Vigilance, alertness, or sustained attention: physiological basis and measurement
Oken, B. S., Salinsky, M. C., & Elsas, S. M. (2006) · Clinical Neurophysiology · doi:10.1016/j.clinph.2006.01.017 · Cited by 887 · see citing works
Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels
Ju, Y.-E. S., Ooms, S. J., Sutphen, C., Macauley, S. L., Zangrilli, M. A., Jerome, G., Fagan, A. M., Mignot, E., Zempel, J. M., Claassen, J. A. H. R., et al. (2017) · Brain · doi:10.1093/brain/awx148 · Cited by 604 · see citing works
Self-citationHypocretin/orexin overexpression induces an insomnia-like phenotype in zebrafish
Prober, D. A., Rihel, J., Onah, A. A., Sung, R.-J., & Schier, A. F. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.4332-06.2006 · Cited by 508 · see citing works
The Epidemiology of Narcolepsy
Longstreth, W. T., Koepsell, T. D., Ton, T. G., Hendrickson, A. F., & van Belle, G. (2007) · Sleep · doi:10.1093/sleep/30.1.13 · Cited by 447 · see citing works
Insights from studying human sleep disorders
Mahowald, M. W., & Schenck, C. H. (2005) · Nature · doi:10.1038/nature04287 · Cited by 330 · see citing works
<i>Hypothalamic Regulation of Sleep and Arousal</i>
Szymusiak, R., & McGinty, D. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1417.027 · Cited by 294 · see citing works
The neurobiological basis of narcolepsy
Mahoney, C. E., Cogswell, A., Koralnik, I. J., & Scammell, T. E. (2019) · Nature Reviews Neuroscience · doi:10.1038/s41583-018-0097-x · Cited by 289 · see citing works
The Functional Role of Dreaming in Emotional Processes
Scarpelli, S., Bartolacci, C., D'Atri, A., Gorgoni, M., & De Gennaro, L. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00459 · Cited by 190 · see citing works
Sleep Neurobiology for the Clinician
(2004) · Sleep · doi:10.1093/sleep/27.4.811 · Cited by 151 · see citing works
Overeem, S., van Nues, S. J., van der Zande, W. L., Donjacour, C. E., van Mierlo, P., & Lammers, G. J. (2011) · Sleep Medicine · doi:10.1016/j.sleep.2010.05.010 · Cited by 144 · see citing works
Self-citationKristensson, K., Nygård, M., Bertini, G., & Bentivoglio, M. (2010) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2009.12.001 · Cited by 140 · see citing works
de Lecea, L., & Sutcliffe, J. G. (2005) · The FEBS Journal · doi:10.1111/j.1742-4658.2005.04981.x · Cited by 105 · see citing works
The immunopathogenesis of narcolepsy type 1
Liblau, R. S., Latorre, D., Kornum, B. R., Dauvilliers, Y., & Mignot, E. J. (2024) · Nature Reviews Immunology · doi:10.1038/s41577-023-00902-9 · Cited by 91 · see citing works
Self-citationOverview of orexin/hypocretin system
Mieda, M., & Sakurai, T. (2012) · Progress in brain research · doi:10.1016/b978-0-444-59489-1.00002-1 · Cited by 64 · see citing works
Neuroscience-driven discovery and development of sleep therapeutics
Dresler, M., Spoormaker, V. I., Beitinger, P., Czisch, M., Kimura, M., Steiger, A., & Holsboer, F. (2014) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2013.10.012 · Cited by 63 · see citing works
CSF hypocretin-1 levels are normal in multiple-system atrophy
Abdo, W. F., Bloem, B. R., Kremer, H. P. H., Lammers, G. J., Verbeek, M. M., & Overeem, S. (2008) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2007.08.012 · Cited by 34 · see citing works
Self-citationSleep disturbances in Parkinson's disease patients and management options
Claassen, D. (2011) · Nature and Science of Sleep · doi:10.2147/nss.s18897 · Cited by 29 · see citing works
- Authors
- Mignot, E., Lammers, G. J., Ripley, B., Okun, M., Nevsimalova, S., Overeem, S., Vankova, J., Black, J., Harsh, J., Bassetti, C., Schrader, H., & Nishino, S.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Mignot, Emmanuel
- ORCID
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2002-10-01
- Volume
- 59
- Issue
- 10
- Pages
- 1553
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W1967884630
- Cited by
- 1,126
- References
- 58
- Citations by year
- 2026: 23 · 2025: 36 · 2024: 27 · 2023: 25 · 2022: 52 · 2021: 32 · 2020: 52 · 2019: 39 · 2018: 35 · 2017: 42 · 2016: 40 · 2015: 49 · 2014: 47 · 2013: 49 · 2012: 56
- FWCI
- 21.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Aquila Digital Community (University of Southern Mississippi) (submittedVersion)
- Funders
- National Institute of Mental Health (MH-40041)
- National Institute of Neurological Disorders and Stroke (NS-23724, NS 33797)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- narcolepsy, orexin-A, orexin, cerebrospinal fluid biomarkers, HLA-DQB1*0602, hypersomnia, cataplexy, diagnostic thresholds, multiple sleep latency test, obstructive sleep apnea, restless legs syndrome, insomnia, Prader-Willi syndrome, Niemann-Pick disease type C
- MeSH terms
- Orexins, Adult, Carrier Proteins, Diagnosis, Differential, Female, Histocompatibility Testing, HLA-DQ Antigens, Humans, Male, Membrane Glycoproteins, Middle Aged, Narcolepsy, Neuropeptides, Sensitivity and Specificity, Sympathomimetics, Biomarkers, Polysomnography, Neurotransmitter Agents, Intracellular Signaling Peptides and Proteins, HLA-DQ beta-Chains
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
