ArticleFrontiers in neuroscience2026
Divergent dFC stability of DMN and SMN in narcolepsy.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Narcolepsy type 1 (NT1) is characterized by profound sleep-wake state instability, pointing to a fundamental dysregulation of large-scale brain network dynamics. To elucidate this, we assessed whole-brain dynamic functional connectivity (dFC) stability using resting-state fMRI in 27 patients with NT1 and 25 matched healthy controls. Our analysis revealed a pattern of opposing alterations: patients exhibited significantly increased dFC stability within the bilateral somatomotor network (SMN), concurrent with decreased stability in the medial prefrontal default mode network (Default_PFCm). These opposing alterations were clinically relevant, as increased SMN stability correlated with poorer objective sleep efficiency, and decreased Default_PFCm stability was similarly associated with lower objective sleep efficiency. Here, we identify for the first time this coexisting neural signature of SMN hyper-stability and Default_PFCm instability in NT1. By simultaneously destabilizing higher-order cognitive networks and disinhibiting primary sensorimotor processing, orexin deficiency may contribute to a synergistic dysregulation that blurs sleep-wake boundaries. The divergence in dynamic network stability provides a novel systems-level framework for understanding state instability in NT1.
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