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Mogavero MP, DelRosso LM, Bruni O, Salemi M, Salsone M, Novellino F, Zucconi M, Ferini Strambi L, Ferri R. Genetics and epigenetics of rare hypersomnia. Trends Genet 2023; 39:415-429. [PMID: 36842900 DOI: 10.1016/j.tig.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/28/2023]
Abstract
Herein we focus on connections between genetics and some central disorders of hypersomnolence - narcolepsy types 1 and 2 (NT1, NT2), idiopathic hypersomnia (IH), and Kleine-Levin syndrome (KLS) - for a better understanding of their etiopathogenetic mechanisms and a better diagnostic and therapeutic definition. Gene pleiotropism influences neurological and sleep disorders such as hypersomnia; therefore, genetics allows us to uncover common pathways to different pathologies, with potential new therapeutic perspectives. An important body of evidence has accumulated on NT1 and IH, allowing a better understanding of etiopathogenesis, disease biomarkers, and possible new therapeutic approaches. Further studies are needed in the field of epigenetics, which has a potential role in the modulation of biological specific hypersomnia pathways.
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Affiliation(s)
- Maria Paola Mogavero
- Vita-Salute San Raffaele University, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Lourdes M DelRosso
- Seattle Children's Hospital and University of Washington, Seattle, WA, USA
| | - Oliviero Bruni
- Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maria Salsone
- Vita-Salute San Raffaele University, Milan, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy
| | - Fabiana Novellino
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Marco Zucconi
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Ferini Strambi
- Vita-Salute San Raffaele University, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
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Martin VP, Lopez R, Dauvilliers Y, Rouas JL, Philip P, Micoulaud-Franchi JA. Sleepiness in adults: An umbrella review of a complex construct. Sleep Med Rev 2023; 67:101718. [PMID: 36455433 DOI: 10.1016/j.smrv.2022.101718] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools designed to measure it in an umbrella review, without any preconceptions, i.e. a review of reviews. We included all reviews and systematic reviews related to sleepiness assessment tools published up to March 2021. Three investigators independently assessed the eligibility of studies for inclusion and identified 36 relevant reviews. In total, 99 tools were identified and classified into 8 categories. We classified them depending on their category, their publication year and the number of mentions in the 36 included reviews. The 6 most frequently cited were the Epworth sleepiness scale, the multiple sleep latency test, the maintenance of wakefulness test, the Stanford sleepiness scale, the Karolinska sleepiness scale, and the psychomotor vigilance task. Despite the limitation that we may have missed some recently developed tools, this historical perspective on sleepiness measurement is a first step toward a better delineation of the different dimensions underlying the constructs of sleepiness, and will serve as a basis for further discussion in the clinical and research sleep community.
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Affiliation(s)
- Vincent P Martin
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
| | - Régis Lopez
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Jean-Luc Rouas
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France
| | - Pierre Philip
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
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A rare genetic variant in the cleavage site of prepro-orexin is associated with idiopathic hypersomnia. NPJ Genom Med 2022; 7:29. [PMID: 35414074 PMCID: PMC9005711 DOI: 10.1038/s41525-022-00298-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/04/2022] [Indexed: 11/08/2022] Open
Abstract
Idiopathic hypersomnia (IH) is a rare, heterogeneous sleep disorder characterized by excessive daytime sleepiness. In contrast to narcolepsy type 1, which is a well-defined type of central disorders of hypersomnolence, the etiology of IH is poorly understood. No susceptibility loci associated with IH have been clearly identified, despite the tendency for familial aggregation of IH. We performed a variation screening of the prepro-orexin/hypocretin and orexin receptors genes and an association study for IH in a Japanese population, with replication (598 patients and 9826 controls). We identified a rare missense variant (g.42184347T>C; p.Lys68Arg; rs537376938) in the cleavage site of prepro-orexin that was associated with IH (minor allele frequency of 1.67% in cases versus 0.32% in controls, P = 2.7 × 10-8, odds ratio = 5.36). Two forms of orexin (orexin-A and -B) are generated from cleavage of one precursor peptide, prepro-orexin. The difference in cleavage efficiency between wild-type (Gly-Lys-Arg; GKR) and mutant (Gly-Arg-Arg; GRR) peptides was examined by assays using proprotein convertase subtilisin/kexin (PCSK) type 1 and PCSK type 2. In both PCSK1 and PCSK2 assays, the cleavage efficiency of the mutant peptide was lower than that of the wild-type peptide. We also confirmed that the prepro-orexin peptides themselves transmitted less signaling through orexin receptors than mature orexin-A and orexin-B peptides. These results indicate that a subgroup of IH is associated with decreased orexin signaling, which is believed to be a hallmark of narcolepsy type 1.
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Miyagawa T, Shimada M, Honda Y, Kodama T, Tokunaga K, Honda M. A variant in orexin receptor-2 is associated with self-reported daytime sleepiness in the Japanese population. J Hum Genet 2022; 67:377-380. [PMID: 35034961 DOI: 10.1038/s10038-022-01015-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 12/21/2022]
Abstract
Excessive daytime sleepiness is characterized by a persistent feeling of having trouble staying awake, typically with inappropriate sleep episodes. Orexin (hypocretin) is a neuropeptide that regulates sleep-wake cycles and rapid eye movement sleep. Several large-scale genome-wide association studies (GWASs) in European populations have found genetic variants in orexin receptor-1 (OX1R) and -2 (OX2R) that are associated with sleep traits including daytime sleepiness. To identify genetic variants associated with daytime sleepiness, we performed an association study of genetic variants in prepro-orexin, OX1R, and OX2R in 14,329 Japanese individuals from the Tohoku Medical Megabank Project cohort. A genetic variant in OX2R was significantly associated with self-reported daytime sleepiness after Bonferroni correction (rs188018846: P = 8.4E-05). In addition, a missense variant in OX2R identified by the European GWASs showed a nominally significant association with daytime sleepiness in a Japanese population (p.Ile308Val, rs2653349: P = 0.044). Multiple genetic variants in OX2R can affect daytime sleepiness in general populations.
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Affiliation(s)
- Taku Miyagawa
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan. .,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Mihoko Shimada
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Genome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiko Honda
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tohru Kodama
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Genome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Honda
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Koishikawa Tokyo Hospital, Institute of Neuropsychiatry, Tokyo, Japan
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