ArticleSleep2016
Cerebrospinal Fluid Orexin A Levels and Autonomic Function in Kleine-Levin Syndrome.
Article in Sleep, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Hypersexuality in neurological disorders: A systematic review.BMJ mental health · 2024Pooled it
- Review
- Narcolepsy is (not) an autoimmune disease.Nature reviews. Neurology · 2026Review
- Present and Future of Central Disorders of Hypersomnolence.Journal of sleep research · 2025Review
- Global research status and trends of compulsive sexual behavior disorder: A comprehensive bibliometric analysis.Journal of behavioral addictions · 2025Review
- Systematic Assessment of Dysexecutive Syndrome, Hypersomnolence and Dysautonomia in Kleine-Levin Syndrome.European journal of neurology · 2025Article
- PET Study of Microglial Activation in Kleine-Levin Syndrome.Neurology(R) neuroimmunology & neuroinflammation · 2024Article
- The Orexin/Hypocretin System, the Peptidergic Regulator of Vigilance, Orchestrates Adaptation to Stress.Biomedicines · 2024Review
- Epigenetic silencing of selected hypothalamic neuropeptides in narcolepsy with cataplexy.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Proteomic biomarkers of Kleine-Levin syndrome.Sleep · 2022Article
- Orexin/Hypocretin System Dysfunction in ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations).Neuropsychiatric disease and treatment · 2022Article
- Kleine-Levin syndrome related to pregnancy: a case report.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Idiopathic Hypersomnia and Other Hypersomnia Syndromes.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Commentary on the Paper by Gagliano et al: Artificial Neural Networks Analysis of Polysomnographic and Clinical Features in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): From Sleep Alteration to "Brain Fog" [Letter].Nature and science of sleep · 2021Article
- Kleine-Levin syndrome: clues to aetiology.Sleep & breathing = Schlaf & Atmung · 2018Review
- Clinical update on central hypersomnias.Journal of thoracic disease · 2018Review
- The sleep architecture of Saudi Arabian patients with Kleine-Levin syndrome.Saudi medical journal · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesKleine-Levin syndrome (KLS) is a rare disorder of relapsing sleepiness. The hypothesis was that the syndrome is related to a change in the vigilance peptide orexin A.
methodsFrom 2002 to 2013, 57 patients with relapsing hypersomnolence were clinically assessed in a referral academic center in Beijing, China, and 44 (28 males and 16 females; mean age 18.3 ± 8.9 y (mean ± standard deviation, range 9-57 y) were determined to have clinical and behavioral criteria consistent with KLS. Cerebrospinal fluid orexin A levels and diurnal blood pressure were measured in relapse versus remission in a subgroup of patients.
resultsPresenting symptoms included relapsing or remitting excessive sleepiness-associated parallel complaints of cognitive changes (82%), eating disorders (84%); depression (45%); irritability (36%); hypersexuality (18%); and compulsions (11%). Episodes were 8.2 ± 3.3 days in duration. In relapse, diurnal values for blood pressure and heart rate were lower (P < 0.001). In a subgroup (n = 34), cerebrospinal fluid orexin A levels were ∼31% lower in a relapse versus remission (215.7 ± 81.5 versus 319.2 ± 95.92 pg/ml, P < 0.001); in three patients a pattern of lower levels during subsequent relapses was documented.
conclusionsThere are lower orexin A levels in the symptomatic phase than in remission and a fall and rise in blood pressure and heart rate, suggesting a role for orexin dysregulation in KLS pathophysiology.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.