Narcolepsy and emotions: Is there a place for a theory of mind approach?

Narcolepsy type 1 is a central disorder of hypersomnolence characterized by excessive daytime sleepiness, rapid eye movement sleep-related manifestations, and cataplexy. In the current literature there is general agreement regarding neural correlates of Narcolepsy type 1 that appear to be related to...

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Bibliographic Details
Published in:Sleep medicine 2023-02, Vol.102, p.84-89
Main Authors: Del Sette, Paola, Veneruso, Marco, Cordani, Ramona, Lecce, Serena, Varallo, Giorgia, Franceschini, Christian, Venturino, Cristina, Pizza, Fabio, Plazzi, Giuseppe, Nobili, Lino
Format: Article
Language:English
Subjects:
Adult
Cataplexy
Disorders of Excessive Somnolence
Emotional processing
Emotions
Humans
Narcolepsy
Pediatric sleep medicine
Theory of Mind
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Summary:Narcolepsy type 1 is a central disorder of hypersomnolence characterized by excessive daytime sleepiness, rapid eye movement sleep-related manifestations, and cataplexy. In the current literature there is general agreement regarding neural correlates of Narcolepsy type 1 that appear to be related to anatomical and functional abnormalities in the hypothalamic region. In the last two decades, researchers shed light on the neurological bases of cataplexy by focusing on the neurobiological correlates of emotions. Although the results of these studies differ, they all point to an impairment in the amygdala and hypothalamus functions that are known to be involved in emotional processing, suggesting an impairment in this domain in narcoleptic patients. Indeed, despite heterogeneous results, several studies showed that narcoleptic patients differed from healthy controls in processing emotional stimuli. From a behavioral point of view, these findings suggest that alterations in emotional processing may be driven, at least in part, by compensatory strategies to avoid or reduce the frequency of cataplexy attacks. Surprisingly, the only study exploring in NT1 the behavioural performances in emotional facial recognition found no differences between NT1 adults and controls. We hypothesize that narcoleptic patients may present an alteration in a more complex socio-cognitive ability that is related to emotional processing, namely Theory of Mind. This review aims to investigate the literature supporting this hypothesis and to propose possible future developments on this topic. •Evidence suggests impaired emotional processing in patients with narcolepsy type 1.•We hypothesize that Theory of Mind skills could be impaired in narcoleptic patients.•Evaluating Theory of Mind abilities could help improve patients' overall outcome.
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2022.12.013