Is there a relationship between narcolepsy, multiple sclerosis and HLA-DQB1*06:02?

Lorenzoni, Paulo José; Werneck, Lineu Cesar; Crippa, Ana Christina de Souza; Zanatta, Alessandra; Kay, Cláudia S. Kamoi; Silvado, Carlos Eduardo S.; Scola, Rosana Herminia

doi:10.1590/0004-282X20170063

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ARTICLE • Arq. Neuro-Psiquiatr. 75 (6) • June 2017 • https://doi.org/10.1590/0004-282X20170063 linkcopy

Is there a relationship between narcolepsy, multiple sclerosis and HLA-DQB1*06:02?

Existe relação entre narcolepsia, esclerose múltipla e HLA-DQB1*06:02?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

We studied multiple sclerosis (MS) patients with the HLA-DQB1*06:02 allele and compared them with MS patients who did not carry the HLA-DQB1*06:02 allele. We analyzed clinical and neurophysiological criteria for narcolepsy in six MS patients with HLA-DQB1*06:02, compared with 12 MS patients who were HLA-DQB1*06:02 non-carriers. Only two patients with HLA-DQB1*06:02 allele scored higher than 10 on the Epworth Sleepiness Scale. Polysomnography recording parameters and the multiple sleep latency test showed an absence of narcolepsy in the study group. Our study suggested no significant correlation between narcolepsy, MS and HLA-DQB1*06:02. The HLA-DQB1*06:02 allele alone was not sufficient to cause MS patients to develop narcolepsy.

narcolepsy; multiple sclerosis; human leukocyte antigen; polysomnography

Case	HLA-DQB1

	Allele 1	Allele 2
Study group
1	02:01	06:02
2	04:02	06:02
3	04:02	06:02
4	03:01	06:02
5	06:02	06:02
6	02:01	06:02
Control group
1	02:03	06:08
2	02:01	05:02
3	06:08	06:08
4	05:01	05:03
5	04:02	04:02
6	05:02	06:05
7	03:02	06:01
8	03:02	03:02
9	02:03	03:04
10	03:01	06:03
11	03:02	03:02
12	02:02	03:02

Variable	Study group*	Control group
Gender (F:M)	04:02	09:03
Age (years)
Mean + SD	46.0 ± 10.7	44.3 ± 12.5
Median (range)	45 (33–64)	47 (23–65)
Follow up time (month)
Mean + SD	131.3 ± 55.7	124.9 ± 47.7
Median (range)	123 (64–224)	130 (29–180)
MS subtype
RR	5	9
SP	1	2
PP	0	1
EDSS score
Mean + SD	4.41 ± 2.81	3.83 ± 2.81
Median (range)	4.25 (1.0–8.5)	3.5 (0.0–9.0)
ESS score
Mean + SD	7 ± 4.85	8 ± 4.43
Median (range)	6.5 (1–13)	8 (0–17)
> 10 points	2	5

Case	1	2	3	4	5	Normal
PSG features
Total sleep time (min)	393	328	314	409	218
Sleep efficiency (%)	80.1	70.27	85.0	83.05	52.72	> 85
Arousal index (N/h)	8.2	7.9	15.5	27.7	14.3
Sleep onset latency (min)	15.0	101.5	14.5	10.0	115.0	< 30
Wake time after sleep onset (min)	49.2	139.0	55.5	83.5	195.5
Stage I (% TST)	8.2	15.0	5.5	20.5	13.7	2–5
Stage II (% TST)	26.0	21.2	45.1	1.3	24.2	45–55
Stage III (% TST)	23.7	27.8	4.3	10.0	14.0	3–8
REM sleep (% TST)	18.3	6.3	30.0	61.2	0.8	20–25
REM onset sleep latency (min)	123.2	118.5	14.5	84.8	408.5	70–90
MSLT features
Mean sleep latency onset (min)	16.4	14.2	15.4	12.0	20.0	> 8
Sleep onset REM episodes	0	0	0	0	0	< 1

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[TFN1] *HLA-DQB1*06:02; F: female; M: male; MS: multiple sclerosis; RR: relapsing-remitting; SP: secondary progressive; PP: primary progressive; EDSS: expanded disability status scale; ESS: Epworth Sleepiness Scale; SD: standard deviation.