中枢性过度睡眠的生物学标志物研究进展OA

Hypersomnias of central origin are defined as the inability to maintain wakefulness and alertness during the major waking episodes of the day,with the manifestation of irrepressible drowsiness or even unprovoked sleep attacks.This spectrum of disorders mainly includes narcolepsy type 1,narcolepsy type 2,idiopathic hypersomnia,and Kleine-Levin syndrome.Currently,the clinical diagnosis of hypersomnias of central origin mainly depends on subjective medical history,sleepiness scales,and electrophysiological assessments,and these conventional diagnostic methods are easily af-fected by confounding factors.A reduction in the level of hypocretin-1 in cerebrospinal fluid(CSF)is the gold standard for the diagnosis of narcolepsy type 1,while there is still a lack of specific and objective laboratory markers for the other sub-types,resulting in the high rates of diagnostic delay and misdiagnosis.As objective and quantifiable indicators for patho-physiological processes,biomarkers have an important clinical value in the early screening,precise phenotyping,and lon-gitudinal monitoring of hypersomnias of central origin,as well as in the development of targeted therapies for this group of sleep disorders.This article systematically reviews the research advances in biomarkers associated with hypersomnias of central origin from the five dimensions of polysomnography and daytime functional assessment,peripheral serology,cere-brospinal fluid,neuroimaging,and autonomic nervous function,in order to provide a theoretical framework and evidence-based support for constructing a precise diagnosis and treatment system for these disorders.